Provider Demographics
NPI:1912945080
Name:THURMAN, NANCY MARIE (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:MARIE
Other - Last Name:THURMAN-WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:CO
Mailing Address - Zip Code:81047-0150
Mailing Address - Country:US
Mailing Address - Phone:719-537-0712
Mailing Address - Fax:719-537-6284
Practice Address - Street 1:1320 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8016
Practice Address - Country:US
Practice Address - Phone:304-388-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42368207L00000X
FL133939207L00000X
WV33625207L00000X
VA0101268568207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO52173364Medicaid
CO540378Medicare ID - Type Unspecified
COC808689Medicare PIN
CO52173364Medicaid
COCO304786Medicare PIN