Healthcare Provider Details

I. General information

NPI: 1124963020
Provider Name (Legal Business Name): WHOLE SELF PRIMARY CARE AND PSYCH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1500 N GRANT ST # 10340
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST # 10340
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 660-422-1359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ANN HUDDLESTON
Title or Position: NURSE PRACTITIONER
Credential: FNP-BC
Phone: 660-422-1359