Healthcare Provider Details

I. General information

NPI: 1699348904
Provider Name (Legal Business Name): AUDREY HENGEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 01/25/2022
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 S POTOMAC ST STE 300
AURORA CO
80012-4510
US

IV. Provider business mailing address

20886 ROBINS DR
DENVER CO
80249-8658
US

V. Phone/Fax

Practice location:
  • Phone: 303-750-0822
  • Fax:
Mailing address:
  • Phone: 605-351-0820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0995801-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: