Provider Demographics
NPI:1699815902
Name:THURMAN-SANCHEZ, LINDA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:THURMAN-SANCHEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 KINGSROYAL BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-1851
Mailing Address - Country:US
Mailing Address - Phone:719-564-0819
Mailing Address - Fax:
Practice Address - Street 1:151 CENTRAL MAIN ST
Practice Address - Street 2:PCCHD
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-4212
Practice Address - Country:US
Practice Address - Phone:719-583-4313
Practice Address - Fax:719-583-4439
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100094163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07020210Medicaid