Healthcare Provider Details

I. General information

NPI: 1124656624
Provider Name (Legal Business Name): RACHEL CUSEO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL DIANE HARDWICK

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8925 RIDGELINE BLVD
HIGHLANDS RANCH CO
80129-2500
US

IV. Provider business mailing address

8925 RIDGELINE BLVD STE 109
HIGHLANDS RANCH CO
80129-2502
US

V. Phone/Fax

Practice location:
  • Phone: 303-471-6500
  • Fax:
Mailing address:
  • Phone: 303-471-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0995462-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: