Basic Information
| Provider Information | |||||||||
| NPI: | 1598045437 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEDBERG | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STROUP | ||||||||
| OtherFirstName: | NANCY | ||||||||
| OtherMiddleName: | JEAN | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4603 W 113TH AVE | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800317820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038884342 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10065 E HARVARD AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802315968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036141493 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2011 | ||||||||
| LastUpdateDate: | 08/23/2011 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 117503 | CO | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 163WL0100X | 117503 | CO | N | Nursing Service Providers | Registered Nurse | Lactation Consultant | 163WM0102X | 117503 | CO | Y | Nursing Service Providers | Registered Nurse | Maternal Newborn | 163WM0705X | 117503 | CO | N | Nursing Service Providers | Registered Nurse | Medical-Surgical |
No ID Information.