MEDICARE: DR. DEBORAH BEDNER KUPECZ NP, PH.D.

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	363LA2200X	Adult Health Nurse Practitioner	RN-62587	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1779	OTHER	CO	VA PRESCRIBER NUMBER

General Provider Information

NPI Number	:	1437245651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH BEDNER KUPECZ NP, PH.D.

Provider Business Mailing Address
First Line	:	500 ONEIDA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-6060
Country	:	US
Telephone Number	:	303-388-5457
Fax Number	:	303-504-2697

Provider Business Practice Location Address
First Line	:	4100 E MISSISSIPPI AVE
Second Line	:	SUITE 1110
City	:	GLENDALE
State	:	CO
Zip	:	80246-3048
Country	:	US
Telephone Number	:	303-504-2691
Fax Number	:	303-504-2697

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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