Healthcare Provider Details

I. General information

NPI: 1285393769
Provider Name (Legal Business Name): BRITTNEY LAUREN CORNELIUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTNEY CORNELIUS

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 SHERMAN ST
DENVER CO
80216-2061
US

IV. Provider business mailing address

4455 E 12TH AVE
DENVER CO
80220-2415
US

V. Phone/Fax

Practice location:
  • Phone: 303-293-8554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: