Provider Demographics
NPI:1275671166
Name:RUBINSON, TRUDY M (NP)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:M
Last Name:RUBINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:720-754-4800
Mailing Address - Fax:720-754-4801
Practice Address - Street 1:1800 WILLIAMS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1238
Practice Address - Country:US
Practice Address - Phone:720-754-4800
Practice Address - Fax:720-754-4801
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO63634363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48481033Medicaid
COCOA103342Medicare PIN