MEDICARE: NICOLE PEDRAZA HIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	0000383	CO

General Provider Information

NPI Number	:	1639002801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE PEDRAZA HIS

Provider Business Mailing Address
First Line	:	5410 W MAGDALENA LN
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-2878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7850 VANCE DR STE 195
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80003-2132
Country	:	US
Telephone Number	:	303-432-3601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ NICOLE PEDRAZA HIS” Practice Location

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