Healthcare Provider Details

I. General information

NPI: 1053826149
Provider Name (Legal Business Name): JOSHUA D GELAUDE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W COUNTY LINE RD
HIGHLANDS RANCH CO
80129-1901
US

IV. Provider business mailing address

9728 BUCKNELL CT
HIGHLANDS RANCH CO
80129-4393
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-7540
  • Fax:
Mailing address:
  • Phone: 303-809-3443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0187270
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: