Healthcare Provider Details

I. General information

NPI: 1700503257
Provider Name (Legal Business Name): ABIGAIL GRACE CASALNOVA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST STE 300
DENVER CO
80205-5503
US

IV. Provider business mailing address

1550 PLATTE ST APT A475
DENVER CO
80202-6151
US

V. Phone/Fax

Practice location:
  • Phone: 303-226-7230
  • Fax: 866-401-9731
Mailing address:
  • Phone: 724-372-4875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number58053
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1679267
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP026310
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number86830
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: