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General NPI Number Information
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NPI Number | 1790838597
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Entity Type | Individual
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Provider Name | JUDY CAROL PONSFORD NP NURSE PRACTITIONE
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 9998 DRANSFELDT RD UNIT A
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City | PARKER
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State | CO
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Zip | 80134-4013
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Country | US
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Telephone | 303-805-5466
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Fax | 303-805-5467
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Provider Business Mailing Address
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Address Line | 6899 S PERTH ST
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City | AURORA
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State | CO
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Zip | 80016
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Country | US
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Telephone | 303-805-5466
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Fax | 303-805-5467
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 108645
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License Number State | CO
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