Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0996142-NP | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0996142-NP | CO |
NPI | 1023605706 |
---|---|
Provider Name | Phebe Golden |
First Address | Pueblo, CO 81008-2285 |
Second Address | Pueblo, CO 81008-2285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2020 |
Last Update Date | 19/02/2021 |