Healthcare Provider Details

I. General information

NPI: 1891305595
Provider Name (Legal Business Name): NICHOLLETTE VICTORIA DYKES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 N SHERMAN ST STE 200
DENVER CO
80203-1132
US

IV. Provider business mailing address

1905 N SHERMAN ST STE 200
DENVER CO
80203-1132
US

V. Phone/Fax

Practice location:
  • Phone: 303-529-6467
  • Fax: 303-622-1128
Mailing address:
  • Phone: 303-529-6467
  • Fax: 303-622-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0002324
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number00001078
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: