Healthcare Provider Details

I. General information

NPI: 1194620286
Provider Name (Legal Business Name): ALTERA HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5827 W IDA DR
LITTLETON CO
80123-0868
US

IV. Provider business mailing address

5827 W IDA DR
LITTLETON CO
80123-0868
US

V. Phone/Fax

Practice location:
  • Phone: 719-839-5801
  • Fax:
Mailing address:
  • Phone: 719-839-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. NICOLE KHAZEI
Title or Position: NURSE PRACTITIONER
Credential: DNP, APRN, AGPCNP-C,
Phone: 719-839-5801