Healthcare Provider Details

I. General information

NPI: 1659795623
Provider Name (Legal Business Name): DENISE RENE DELGADO RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 11TH ST
GREELEY CO
80631-3608
US

IV. Provider business mailing address

713 WHEAT RIDGE LN UNIT 204
LAS VEGAS NV
89145-2944
US

V. Phone/Fax

Practice location:
  • Phone: 702-577-7536
  • Fax:
Mailing address:
  • Phone: 702-577-7536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN.0202182
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN49994
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: