Healthcare Provider Details

I. General information

NPI: 1083885339
Provider Name (Legal Business Name): NICOLE CORRINE SEIS RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 E 14TH PL SUITE 309
AURORA CO
80011-5818
US

IV. Provider business mailing address

6162 S. WILLOW DRIVE SUITE 100
GREENWOOD VILLAGE CO
80111-5114
US

V. Phone/Fax

Practice location:
  • Phone: 303-341-9370
  • Fax: 303-367-2597
Mailing address:
  • Phone: 303-220-9200
  • Fax: 303-220-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number181928
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: