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General NPI Number Information
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NPI Number | 1649461716
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Entity Type | Individual
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Provider Name | JOEY PETER MARTSOLF CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 1551 PROFESSIONAL LN
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City | LONGMONT
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State | CO
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Zip | 80501-6972
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Country | US
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Telephone | 303-640-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 382 S ARTHUR AVE
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City | LOUISVILLE
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State | CO
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Zip | 80027-3094
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Country | US
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Telephone | 303-604-5000
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP60905089
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN532761
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0998027
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License Number State | CO
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