Healthcare Provider Details

I. General information

NPI: 1477126209
Provider Name (Legal Business Name): MICHELLE DENISE LUGO NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E HARVARD AVE STE 405
DENVER CO
80210-5077
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 301
HIGHLANDS RANCH CO
80129-2277
US

V. Phone/Fax

Practice location:
  • Phone: 303-584-8900
  • Fax: 303-584-0525
Mailing address:
  • Phone: 303-584-8900
  • Fax: 303-584-0525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0996715-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: