Provider Demographics
NPI:1275969149
Name:DUTENHOFFER, ANNETTE (CS)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:DUTENHOFFER
Suffix:
Gender:F
Credentials:CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 ANTERO DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2054
Mailing Address - Country:US
Mailing Address - Phone:303-485-5885
Mailing Address - Fax:
Practice Address - Street 1:1733 ANTERO DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-2054
Practice Address - Country:US
Practice Address - Phone:303-485-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner