Provider Demographics
NPI:1831459692
Name:TUETING, JOSHUA G (APNP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:G
Last Name:TUETING
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 WARDENBURG DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80309-0001
Mailing Address - Country:US
Mailing Address - Phone:303-492-5432
Mailing Address - Fax:303-492-6861
Practice Address - Street 1:1900 WARDENBURG
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-1911
Practice Address - Country:US
Practice Address - Phone:303-492-5432
Practice Address - Fax:303-492-6861
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4948-33363L00000X
CO772CNP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1831459692Medicaid
WI1831459692Medicaid
WI1831459692Medicaid
WI150350057Medicare PIN
WI303450227Medicare PIN