Healthcare Provider Details

I. General information

NPI: 1619778131
Provider Name (Legal Business Name): RUNA PRADHAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8354 E NORTHFIELD BLVD # 329
DENVER CO
80238-3131
US

IV. Provider business mailing address

8354 E NORTHFIELD BLVD # 329
DENVER CO
80238-3131
US

V. Phone/Fax

Practice location:
  • Phone: 720-607-9207
  • Fax: 720-738-7873
Mailing address:
  • Phone: 720-607-9207
  • Fax: 720-738-7873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1000680
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: