Healthcare Provider Details

I. General information

NPI: 1003959552
Provider Name (Legal Business Name): SHARON K BALDIZAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

13702 KEARNEY ST
THORNTON CO
80602-9172
US

V. Phone/Fax

Practice location:
  • Phone: 720-536-7462
  • Fax:
Mailing address:
  • Phone: 303-451-8524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: