MEDICARE: MS. SUSAN KAY GLEASON RN

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	41325	CO

General Provider Information

NPI Number	:	1265710677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN KAY GLEASON RN

Provider Business Mailing Address
First Line	:	893 S OSWEGO CT
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-3258
Country	:	US
Telephone Number	:	303-908-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	10065 E HARVARD AVE
Second Line	:	SUITE 400
City	:	DENVER
State	:	CO
Zip	:	80231-5968
Country	:	US
Telephone Number	:	303-614-1400
Fax Number	:

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

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	06/14/2026

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