Healthcare Provider Details

I. General information

NPI: 1992901938
Provider Name (Legal Business Name): LAURA A GREENE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 S PARKER RD SUTIE 100
AURORA CO
80014-2911
US

IV. Provider business mailing address

500 ELDORADO BLVD SUITE 6250
DENVER CO
80021-3408
US

V. Phone/Fax

Practice location:
  • Phone: 303-481-7030
  • Fax: 303-745-7665
Mailing address:
  • Phone: 303-425-8000
  • Fax: 303-272-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5296
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: