Provider Demographics
NPI:1720055890
Name:TWARDOWSKI, DEBORAH L (RN MSN CS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:TWARDOWSKI
Suffix:
Gender:F
Credentials:RN MSN CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1727
Mailing Address - Street 2:
Mailing Address - City:GRAND JCT
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1727
Mailing Address - Country:US
Mailing Address - Phone:970-241-7600
Mailing Address - Fax:970-263-4831
Practice Address - Street 1:743 HORIZON CT
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8701
Practice Address - Country:US
Practice Address - Phone:970-241-7600
Practice Address - Fax:970-263-4831
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO98667363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
98667OtherCOLORADO BOARD ME
MT1340417OtherDEA