Individual
SUSAN LYNN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3482 BROADWAY ST, BOULDER, CO 80304-1824
(303) 441-1100
Mailing address
3450 BROADWAY ST, BOULDER, CO 80304-1824
(804) 833-1931
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1666821
CO
Other
Enumeration date
09/17/2020
Last updated
09/18/2020
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