Healthcare Provider Details

I. General information

NPI: 1942039607
Provider Name (Legal Business Name): ROYAL OAK HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 LINDEN ST STE 1
LONGMONT CO
80501-3289
US

IV. Provider business mailing address

1151 EAGLE DR # 311
LOVELAND CO
80537-8020
US

V. Phone/Fax

Practice location:
  • Phone: 720-600-4637
  • Fax: 720-815-0443
Mailing address:
  • Phone: 970-412-2395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELISSA MOORE
Title or Position: OWNER
Credential: BSN, RN, FNP-C
Phone: 970-412-2395