Provider Demographics
NPI:1649229972
Name:HARCROW, JUDITH (NP,RXN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HARCROW
Suffix:
Gender:F
Credentials:NP,RXN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 MCINTYRE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7445
Mailing Address - Country:US
Mailing Address - Phone:303-525-7250
Mailing Address - Fax:303-531-5088
Practice Address - Street 1:5920 MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-7445
Practice Address - Country:US
Practice Address - Phone:303-525-7250
Practice Address - Fax:303-531-5088
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86285163WH1000X
CO3070363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96324732Medicaid
COCOA105072Medicare PIN