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General NPI Number Information
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NPI Number | 1619789161
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Entity Type | Individual
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Provider Name | GARY HERBERT DUEHR RN CASE MANAGER
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Gender | Male
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 559 VINCENT ST. SPACE BASE DELTA 1 PETERSON SPACE FORCE BASE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80914-1541
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Country | US
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Telephone | 719-556-7295
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Fax | 719-556-6876
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Provider Business Mailing Address
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Address Line | 559 VINCENT ST. SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80914-1541
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Country | US
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Telephone | 719-556-7295
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Fax | 719-556-6876
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN.1643408
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License Number State | CO
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