Healthcare Provider Details

I. General information

NPI: 1265104798
Provider Name (Legal Business Name): ELLEN MARIE HUGHES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2021
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 COLE BLVD STE 210
LAKEWOOD CO
80401-3304
US

IV. Provider business mailing address

12303 E ARIZONA DR
AURORA CO
80012
US

V. Phone/Fax

Practice location:
  • Phone: 303-747-5051
  • Fax: 724-204-1648
Mailing address:
  • Phone: 970-216-6794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1645857
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0998105
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: