Healthcare Provider Details

I. General information

NPI: 1790084788
Provider Name (Legal Business Name): CARRI R HOLTON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRI DELAHUNTY RN

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 07/21/2022
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

8383 W ALAMEDA AVE
LAKEWOOD CO
80226-3007
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number164210
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0992747
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0992747
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: