Healthcare Provider Details

I. General information

NPI: 1598049629
Provider Name (Legal Business Name): ROBERTA-LYN KURRONEN NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CONCORD TER
SUNRISE FL
33323-2843
US

IV. Provider business mailing address

6492 S TAFT WAY
LITTLETON CO
80127-4842
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-3839
  • Fax:
Mailing address:
  • Phone: 503-702-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0991591
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: