Healthcare Provider Details

I. General information

NPI: 1679436695
Provider Name (Legal Business Name): SY LIN LE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 E 19TH AVE RM P15-5020
AURORA CO
80045-2560
US

IV. Provider business mailing address

12700 E 19TH AVE RM P15-5020
AURORA CO
80045-2560
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001309-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: