Individual
KAREN M VANDEWEGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.,BSN
Contact information
Practice address
1525 BLUE SPRUCE DR, FORT COLLINS, CO 80524-2004
(970) 498-6756
(970) 498-6772
Mailing address
1403 PURPLE SAGE CT, FORT COLLINS, CO 80526-3042
(970) 223-2701
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
51832
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07518327
—
CO
Enumeration date
05/29/2007
Last updated
07/08/2007
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