Provider Demographics
NPI:1457576852
Name:YOUNGQUIST, JO L (RN)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:L
Last Name:YOUNGQUIST
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 1:1660 S TRENTON CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5685
Mailing Address - Country:US
Mailing Address - Phone:303-755-5510
Mailing Address - Fax:303-755-7104
Practice Address - Street 1:1660 S TRENTON CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5685
Practice Address - Country:US
Practice Address - Phone:303-755-5510
Practice Address - Fax:303-755-7104
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO54082163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant