Healthcare Provider Details

I. General information

NPI: 1689355307
Provider Name (Legal Business Name): THELMA SERENA BAAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5822 S LOWELL WAY
LITTLETON CO
80123-2849
US

IV. Provider business mailing address

8181 E TUFTS AVE STE 560
DENVER CO
80237-2559
US

V. Phone/Fax

Practice location:
  • Phone: 720-669-3470
  • Fax:
Mailing address:
  • Phone: 720-669-3470
  • Fax: 720-669-3480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0998855
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: