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General NPI Number Information
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NPI Number | 1124744834
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Entity Type | Organization
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Legal Business Name | VIDA IV HYDRATION AND WELLNESS, LLC
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 1221 28TH AVE STE 5
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City | GREELEY
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State | CO
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Zip | 80634-5466
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Country | US
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Telephone | 970-702-4934
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Fax |
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Provider Business Mailing Address
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Address Line | 6823 W 28TH ST
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City | GREELEY
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State | CO
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Zip | 80634-9656
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Country | US
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Telephone | 970-702-4934
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. ERIKA I KUHN
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Credential | NP
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Telephone | 970-702-4934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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