Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APN.0993530-NP | CO |
NPI | 1003143850 |
---|---|
Provider Name | Qing Xu |
First Address | Lafayette, CO 80026-9073 |
Second Address | Lakewood, CO 80226-1023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2009 |
Last Update Date | 02/12/2017 |