Healthcare Provider Details

I. General information

NPI: 1649042888
Provider Name (Legal Business Name): SUE ANN VIGIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 19TH AVE
DENVER CO
80218-1114
US

IV. Provider business mailing address

11423 IRON ORE CT
PARKER CO
80134-6119
US

V. Phone/Fax

Practice location:
  • Phone: 303-813-4000
  • Fax:
Mailing address:
  • Phone: 303-591-1348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRXN.0109955-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0120448
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: