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General NPI Number Information
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NPI Number | 1912896663
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Entity Type | Individual
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Provider Name | SHARON B KECK RN, MSN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1950 MOUNTAIN VIEW AVE
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City | LONGMONT
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State | CO
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Zip | 80501-3129
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Country | US
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Telephone | 303-884-8517
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Fax |
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Provider Business Mailing Address
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Address Line | 7407 PARK CIR
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City | BOULDER
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State | CO
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Zip | 80301-3958
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Country | US
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Telephone | 303-530-1093
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | RN-.1632439
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License Number State | CO
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