Individual
MICHAEL NESGODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3303 N. BROADWAY, BOULDER, CO 80304
(303) 449-6050
Mailing address
1345 PLAZA CT N, 1A, LAFAYETTE, CO 80026-3531
(303) 449-6050
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
129061
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129061
LICENSE
CO
Enumeration date
05/04/2007
Last updated
07/16/2007
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