Healthcare Provider Details

I. General information

NPI: 1730093584
Provider Name (Legal Business Name): BRIAN L FUN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 FILLMORE ST
DENVER CO
80206-4322
US

IV. Provider business mailing address

350 FILLMORE ST
DENVER CO
80206-4322
US

V. Phone/Fax

Practice location:
  • Phone: 303-887-6577
  • Fax:
Mailing address:
  • Phone: 303-887-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1663651
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: