Healthcare Provider Details

I. General information

NPI: 1295671485
Provider Name (Legal Business Name): LUPA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 S HOWES ST UNIT 200-B
FORT COLLINS CO
80521-2802
US

IV. Provider business mailing address

418 S HOWES ST UNIT 200-B
FORT COLLINS CO
80521-2802
US

V. Phone/Fax

Practice location:
  • Phone: 516-353-2092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: EMMA RICHARDSON
Title or Position: OWNER
Credential: PA-C
Phone: 516-353-2092