MEDICARE: MS. ANN THURSTON N.P.

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	363LF0000X	Family Nurse Practitioner	110145	CO
2	363L00000X	Nurse Practitioner	110145	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	808795	OTHER	CO	MEMORIAL HEALTH SYSTEMS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295707032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN THURSTON N.P.

Provider Business Mailing Address
First Line	:	2880 INTERNATIONAL CIR # N010
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3127
Country	:	US
Telephone Number	:	719-520-7080
Fax Number	:	719-520-7088

Provider Business Practice Location Address
First Line	:	2880 INTERNATIONAL CIR # N010
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3127
Country	:	US
Telephone Number	:	719-520-7080
Fax Number	:	719-520-7086

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	11/20/2018

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Directions to “ MS. ANN THURSTON N.P.” Practice Location

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