Healthcare Provider Details

I. General information

NPI: 1720683113
Provider Name (Legal Business Name): CAILIN A HOLLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1746 COLE BLVD
LAKEWOOD CO
80401-3208
US

IV. Provider business mailing address

1746 COLE BLVD
LAKEWOOD CO
80401-3208
US

V. Phone/Fax

Practice location:
  • Phone: 443-388-3948
  • Fax:
Mailing address:
  • Phone: 443-388-3948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001080
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: