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General NPI Number Information
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NPI Number | 1558579615
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Entity Type | Individual
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Provider Name | SHARON FORTINO RN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16290 E QUINCY AVE
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City | AURORA
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State | CO
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Zip | 80015-1594
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Country | US
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Telephone | 303-360-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 9242 E MORNING STAR PL
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City | PARKER
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State | CO
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Zip | 80134-5611
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 87290
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License Number State | CO
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