Healthcare Provider Details

I. General information

NPI: 1215179809
Provider Name (Legal Business Name): BETH MICHELLE BOULDEN WARREN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH MICHELLE BOULDEN

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13199 E MONTVIEW BLVD
AURORA CO
80045-7202
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0051004
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number0051004
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: