Provider Demographics
NPI:1336588003
Name:QUESADA, LETICIA EVELYN (RN)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:EVELYN
Last Name:QUESADA
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 1:857 S NAPLES WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3170
Mailing Address - Country:US
Mailing Address - Phone:970-306-9455
Mailing Address - Fax:
Practice Address - Street 1:857 S NAPLES WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3170
Practice Address - Country:US
Practice Address - Phone:970-306-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20082163WC0400X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health