Healthcare Provider Details

I. General information

NPI: 1548107402
Provider Name (Legal Business Name): LAUREN MARTIN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 ALBROOK DR
DENVER CO
80239-4604
US

IV. Provider business mailing address

4699 KITTREDGE ST UNIT 13310
DENVER CO
80239-5781
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTL0011516
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: