Healthcare Provider Details

I. General information

NPI: 1679784342
Provider Name (Legal Business Name): BOULDER VALLEY WOMEN'S HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 VALMONT RD
BOULDER CO
80301-1309
US

IV. Provider business mailing address

2855 VALMONT RD
BOULDER CO
80301-1309
US

V. Phone/Fax

Practice location:
  • Phone: 303-440-9230
  • Fax:
Mailing address:
  • Phone: 303-440-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number StateCO

VIII. Authorized Official

Name: SUSAN LEVY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-440-9320