Healthcare Provider Details

I. General information

NPI: 1306759089
Provider Name (Legal Business Name): PAIGE RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16592 HIGH DESERT PL
PARKER CO
80134-3044
US

IV. Provider business mailing address

1945 DOMINION WAY STE 110
COLORADO SPRINGS CO
80918-1474
US

V. Phone/Fax

Practice location:
  • Phone: 720-458-5413
  • Fax: 720-815-0397
Mailing address:
  • Phone: 720-458-5413
  • Fax: 720-815-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1002468-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: