Healthcare Provider Details

I. General information

NPI: 1497329924
Provider Name (Legal Business Name): LYNDEE LERETTE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 02/09/2022
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HALE PKWY STE 340
DENVER CO
80220-4000
US

IV. Provider business mailing address

4600 HALE PKWY STE 340
DENVER CO
80220-4000
US

V. Phone/Fax

Practice location:
  • Phone: 303-280-0900
  • Fax: 303-280-3858
Mailing address:
  • Phone: 303-280-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN.1648182
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN.0096540-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0096540-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: