Healthcare Provider Details

I. General information

NPI: 1033314265
Provider Name (Legal Business Name): CHRISTY SUE BORUD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 UNION BLVD STE 200
LAKEWOOD CO
80228-1833
US

IV. Provider business mailing address

557 CRAWFORD ST
GOLDEN CO
80401-4897
US

V. Phone/Fax

Practice location:
  • Phone: 303-763-5111
  • Fax: 303-763-9520
Mailing address:
  • Phone: 303-984-9831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number02-113
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: