MEDICARE: QUEEN NWOKE RN, BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.1646679	CO

General Provider Information

NPI Number	:	1144932906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUEEN NWOKE RN, BSN

Provider Business Mailing Address
First Line	:	4675 S DILLON CT UNIT A
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-1159
Country	:	US
Telephone Number	:	303-257-6481
Fax Number	:

Provider Business Practice Location Address
First Line	:	6005 S HOLLY ST
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80121-3460
Country	:	US
Telephone Number	:	303-773-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2022
Last Update Date	:	12/22/2022

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