Individual
COURTNEY FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1301 E 7TH ST, PUEBLO, CO 81001-3508
(719) 543-8711
(719) 543-0171
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-0171
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
C-APN.0000757-C-NP
CO
363L00000X
Nurse Practitioner
3007065
KY
363L00000X
Nurse Practitioner
Primary
APN.0996053-NP
CO
363L00000X
Nurse Practitioner
C-APN.0000757-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000145670
—
CO
Enumeration date
08/22/2011
Last updated
05/22/2024
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