Healthcare Provider Details

I. General information

NPI: 1801265350
Provider Name (Legal Business Name): HEBAH REFAAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 16TH ST
GREELEY CO
80631-5114
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2127
  • Fax: 970-652-2447
Mailing address:
  • Phone: 970-624-2404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number991639
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: