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 1:102 NOLAND CT
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-3802
Mailing Address - Country:US
Mailing Address - Phone:303-498-5941
Mailing Address - Fax:
Practice Address - Street 1:435 HIGH ST,
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540
Practice Address - Country:US
Practice Address - Phone:303-498-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO772CNP363LA2200X
WI4948-33363L00000X
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