Provider Demographics
NPI:1063670263
Name:WEIMER, JUDITH HELENE (RN, MSN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:HELENE
Last Name:WEIMER
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 DTC PKWY
Mailing Address - Street 2:#400
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2709
Mailing Address - Country:US
Mailing Address - Phone:303-745-0000
Mailing Address - Fax:
Practice Address - Street 1:5200 DTC PKWY
Practice Address - Street 2:#400
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2709
Practice Address - Country:US
Practice Address - Phone:303-745-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO77370082Medicaid
CO448853YKMEMedicare PIN