Healthcare Provider Details

I. General information

NPI: 1639596679
Provider Name (Legal Business Name): LAUREN RENEE ANDERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 E 17TH PL
AURORA CO
80045-2570
US

IV. Provider business mailing address

13001 E. 17TH PLACE UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME
AURORA CO
80045-2581
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6738
  • Fax: 720-777-7258
Mailing address:
  • Phone: 720-777-6738
  • Fax: 720-777-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0058483
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: