Provider Demographics
NPI:1619340551
Name:DUARTE, VICTOR (FNP-C, WCC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:DUARTE
Suffix:
Gender:M
Credentials:FNP-C, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 FALCON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-5100
Mailing Address - Country:US
Mailing Address - Phone:970-217-4896
Mailing Address - Fax:
Practice Address - Street 1:1914 FALCON RIDGE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-5100
Practice Address - Country:US
Practice Address - Phone:970-217-4896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-31
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991521-NP363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner