Healthcare Provider Details

I. General information

NPI: 1306676838
Provider Name (Legal Business Name): BAXTER STEWART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 W COAL MINE AVE STE 240
LITTLETON CO
80127-5407
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 450
HIGHLANDS RANCH CO
80129-2255
US

V. Phone/Fax

Practice location:
  • Phone: 303-276-0300
  • Fax: 720-645-2998
Mailing address:
  • Phone: 303-357-2559
  • Fax: 720-645-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11741656-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: