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General NPI Number Information
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NPI Number | 1245014828
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Entity Type | Individual
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Provider Name | EMILY ANNE SOUDERS DNP, FNP-BC, APN
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Gender | Female
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 257 BOARDWALK DR
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City | FORT COLLINS
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State | CO
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Zip | 80525-3661
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Country | US
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Telephone | 970-207-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 ROSEN DR APT 4-202
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City | FORT COLLINS
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State | CO
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Zip | 80528-2008
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Country | US
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Telephone | 765-404-8359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 28243824A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0102892-C-NP
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License Number State | CO
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