Individual
EMILIE MARTEL-ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 KEN PRATT BLVD STE 104G, LONGMONT, CO 80501-6568
(303) 415-4246
(303) 415-8407
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 415-4246
(303) 415-8407
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60810574
WA
363L00000X
Nurse Practitioner
C-APN.0102280-C-APN
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
C-APN.0102280-C-NP
CO
Other
Enumeration date
09/06/2023
Last updated
09/27/2024
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