Basic Information
Provider Information
NPI: 1720105133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCURDY-NUTT
FirstName: LINDA
MiddleName: PEARL
NamePrefix: MRS.
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5365 E THRILL PL
Address2:  
City: DENVER
State: CO
PostalCode: 802072019
CountryCode: US
TelephoneNumber: 3033881598
FaxNumber:  
Practice Location
Address1: 1733 VINE VINE ST.
Address2:  
City: DENVER
State: CO
PostalCode: 80206
CountryCode: US
TelephoneNumber: 3035041000
FaxNumber: 3033949820
Other Information
ProviderEnumerationDate: 03/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X37560COY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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