Provider Demographics
NPI:1790838597
Name:PONSFORD, JUDY CAROL (NP NURSE PRACTITIONE)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:CAROL
Last Name:PONSFORD
Suffix:
Gender:F
Credentials:NP NURSE PRACTITIONE
Other - Prefix:MISS
Other - First Name:JUDY
Other - Middle Name:CAROL
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:6899 S PERTH ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:303-805-5466
Mailing Address - Fax:303-805-5467
Practice Address - Street 1:9998 DRANSFELDT RD
Practice Address - Street 2:UNIT A
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4013
Practice Address - Country:US
Practice Address - Phone:303-805-5466
Practice Address - Fax:303-805-5467
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO108645363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner