Healthcare Provider Details

I. General information

NPI: 1477901304
Provider Name (Legal Business Name): ABIGAIL L WEGERT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 W ALAMEDA AVE STE 260
LAKEWOOD CO
80226
US

IV. Provider business mailing address

4900 S MONACO ST STE 210
DENVER CO
80237-3487
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-3477
  • Fax: 303-733-5848
Mailing address:
  • Phone: 303-744-3477
  • Fax: 303-733-5848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1639869
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number992471
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: