Individual provider · Type 1 NPI
Ethan Doe
Case Management Registered Nurse · Boulder, CO
NPI number
1134098833
Active
Practice location
3180 Airport Rd
Boulder, CO 80301-2208
Mailing address
11823 Ridge Pkwy Apt 817
Broomfield, CO 80021-5099
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Management Registered Nurse Primary | 163WC0400X | RN.1675791 (CO) |
Case Management Registered Nurse: Definition to come...
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About NPI 1134098833
Ethan Doe's National Provider Identifier is 1134098833, issued on Oct 31, 2025. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in Boulder, CO. The record was last updated on Oct 31, 2025.