Healthcare Provider Details

I. General information

NPI: 1790220267
Provider Name (Legal Business Name): BAMBI C STRUCK AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7936 E ARAPAHOE CT STE 1800
CENTENNIAL CO
80112-6823
US

IV. Provider business mailing address

7936 E ARAPAHOE CT STE 1800
CENTENNIAL CO
80112-6823
US

V. Phone/Fax

Practice location:
  • Phone: 720-647-5768
  • Fax:
Mailing address:
  • Phone: 720-647-5768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0992778-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: