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General NPI Number Information
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NPI Number | 1730115452
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Entity Type | Individual
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Provider Name | LAURIE BORTHWICK FNP
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Gender | Female
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 SOUTH DRIVE COLORADO STATE UNIVERSITY HEALTH CENTER
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City | FORT COLLINS
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State | CO
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Zip | 80523-0001
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Country | US
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Telephone | 970-491-1754
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Fax | 970-491-0226
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Provider Business Mailing Address
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Address Line | 212 LINDA LN
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City | FORT COLLINS
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State | CO
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Zip | 80525-2554
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Country | US
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Telephone | 970-266-1683
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Fax | 970-491-0226
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 98525
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License Number State | CO
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