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General NPI Number Information
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NPI Number | 1811422082
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Entity Type | Organization
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Legal Business Name | DOCTOR NURSE PRACTICE, LLC
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 1921 N 17TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8533
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Country | US
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Telephone | 970-312-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 N 17TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8533
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Country | US
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Telephone | 970-312-7000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JUDITH A SHUE
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Credential | DNP, RN, FNP-BC
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Telephone | 970-312-7000
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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 | APN.0992346-NP
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License Number State | CO
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