Healthcare Provider Details

I. General information

NPI: 1568307890
Provider Name (Legal Business Name): ANNE HAAKENSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 ARAPAHOE AVE
BOULDER CO
80303-1385
US

IV. Provider business mailing address

317 MCCONNELL DR
LYONS CO
80540-3806
US

V. Phone/Fax

Practice location:
  • Phone: 303-385-2000
  • Fax: 303-930-5580
Mailing address:
  • Phone: 303-385-2000
  • Fax: 303-930-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0173721
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: