Provider Demographics
NPI:1477798536
Name:PROFESIONAL NURSING FOOT CARE
Entity Type:Organization
Organization Name:PROFESIONAL NURSING FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:303-347-8848
Mailing Address - Street 1:PO BOX 2199
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-1413
Mailing Address - Country:US
Mailing Address - Phone:303-347-8848
Mailing Address - Fax:
Practice Address - Street 1:6360 W CENTER AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3401
Practice Address - Country:US
Practice Address - Phone:303-347-8848
Practice Address - Fax:303-997-6123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12867261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric