Provider Demographics
NPI:1760921068
Name:BRONSKI, JULIET SMITH
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:SMITH
Last Name:BRONSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 POTOMAC ST STE 111
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6743
Mailing Address - Country:US
Mailing Address - Phone:303-343-3121
Mailing Address - Fax:
Practice Address - Street 1:750 POTOMAC ST STE 111
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6743
Practice Address - Country:US
Practice Address - Phone:303-343-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1625893163W00000X
COANP.0992856-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse