Healthcare Provider Details

I. General information

NPI: 1063821767
Provider Name (Legal Business Name): BENJAMIN LARRABEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6222 E PINE LN STE 6212 #1078
PARKER CO
80138-8713
US

IV. Provider business mailing address

6222 E PINE LN STE 6212 #1078
PARKER CO
80138-8713
US

V. Phone/Fax

Practice location:
  • Phone: 720-432-0494
  • Fax:
Mailing address:
  • Phone: 720-432-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0040457
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: