Healthcare Provider Details

I. General information

NPI: 1356919740
Provider Name (Legal Business Name): HOLLY WEISHEIT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9218 KIMMER DR STE 207
LONE TREE CO
80124-6733
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 720-493-9006
  • Fax: 720-242-7520
Mailing address:
  • Phone: 720-493-9006
  • Fax: 720-242-7520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0996549-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: