Healthcare Provider Details

I. General information

NPI: 1710807789
Provider Name (Legal Business Name): LINDA STILL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 S QUEBEC ST # A3122
CENTENNIAL CO
80112-4411
US

IV. Provider business mailing address

8200 S QUEBEC ST # A3122
CENTENNIAL CO
80112-4411
US

V. Phone/Fax

Practice location:
  • Phone: 303-241-2582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0202252
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: