Provider Demographics
NPI:1801443239
Name:GBEUGRE, JOSEPHA ALEXANDRA
Entity type:Individual
Prefix:
First Name:JOSEPHA
Middle Name:ALEXANDRA
Last Name:GBEUGRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 E GIRARD AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5092
Mailing Address - Country:US
Mailing Address - Phone:424-215-4608
Mailing Address - Fax:
Practice Address - Street 1:9600 E GIRARD AVE APT 3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5082
Practice Address - Country:US
Practice Address - Phone:424-215-4608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00757988376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide