Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | CO76975 | CO |
NPI | 1134425630 |
---|---|
Provider Name | Richelle M Amundson |
First Address | Denver, CO 80291-1057 |
Second Address | Westminster, CO 80031-3807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2011 |
Last Update Date | 31/01/2011 |