Provider Demographics
NPI:1467153270
Name:LONGORIA, GELARE (RN)
Entity Type:Individual
Prefix:
First Name:GELARE
Middle Name:
Last Name:LONGORIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GELY
Other - Middle Name:
Other - Last Name:LONGORIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1460 TRUDA DR
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1277
Mailing Address - Country:US
Mailing Address - Phone:720-217-8884
Mailing Address - Fax:303-420-8831
Practice Address - Street 1:3555 LUTHERAN PKWY STE 340
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6039
Practice Address - Country:US
Practice Address - Phone:303-996-6005
Practice Address - Fax:303-420-8831
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1646325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse