Healthcare Provider Details

I. General information

NPI: 1851381487
Provider Name (Legal Business Name): LISA AHRENDT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 E HAMPDEN AVE SUITE 500
ENGLEWOOD CO
80113
US

IV. Provider business mailing address

799 E HAMPDEN AVE SUITE 500
ENGLEWOOD CO
80113
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8675
  • Fax: 303-761-8031
Mailing address:
  • Phone: 303-788-8675
  • Fax: 303-761-8031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number42824
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: