Healthcare Provider Details

I. General information

NPI: 1336726090
Provider Name (Legal Business Name): CORINNA GRACE VANNOZZI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E HAMPDEN AVE STE 360
ENGLEWOOD CO
80113-3877
US

IV. Provider business mailing address

499 E HAMPDEN AVE STE 360
ENGLEWOOD CO
80113-3877
US

V. Phone/Fax

Practice location:
  • Phone: 303-762-3450
  • Fax: 303-761-0553
Mailing address:
  • Phone: 303-762-3450
  • Fax: 303-761-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR.0077830
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: