1710329073 NPI number — JUVY QUINTO RN, MSN, FNP

Table of content: (NPI 1043240310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710329073 NPI number — JUVY QUINTO RN, MSN, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTO
Provider First Name:
JUVY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, FNP
Provider Gender Code:
F

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:
1710329073
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4891 INDEPENDENCE ST
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
WHEAT RIDGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80033-6752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-456-5495
Provider Business Mailing Address Fax Number:
303-456-7490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2655 CRESCENT DR
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80026-3372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-443-4200
Provider Business Practice Location Address Fax Number:
303-443-5470
Provider Enumeration Date:
07/26/2013

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: 163WN0300X , with the licence number:  126406 , 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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