Healthcare Provider Details

I. General information

NPI: 1376994822
Provider Name (Legal Business Name): ELIZABETH LEFEBRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WARDENBURG DRIVE
BOULDER CO
80309-0119
US

IV. Provider business mailing address

1309 INVERNESS DR
LAFAYETTE CO
80026-1860
US

V. Phone/Fax

Practice location:
  • Phone: 303-492-5101
  • Fax:
Mailing address:
  • Phone: 678-793-7514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number701458
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1663819
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number341541
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0104324
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: