1619789161 NPI number — GARY HERBERT DUEHR RN CASE MANAGER

Table of content: GARY HERBERT DUEHR RN CASE MANAGER (NPI 1619789161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619789161 NPI number — GARY HERBERT DUEHR RN CASE MANAGER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUEHR
Provider First Name:
GARY
Provider Middle Name:
HERBERT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN CASE MANAGER
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619789161
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
559 VINCENT ST. SPACE BASE DELTA 1,
Provider Second Line Business Mailing Address:
PETERSON SPACE FORCE BASE
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80914-1541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-556-7295
Provider Business Mailing Address Fax Number:
719-556-6876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
559 VINCENT ST. SPACE BASE DELTA 1
Provider Second Line Business Practice Location Address:
PETERSON SPACE FORCE BASE
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80914-1541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-556-7295
Provider Business Practice Location Address Fax Number:
719-556-6876
Provider Enumeration Date:
01/22/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC0400X , with the licence number:  RN.1643408 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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