Healthcare Provider Details

I. General information

NPI: 1063200053
Provider Name (Legal Business Name): VIDA PLENA WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 W 84TH AVE STE 180
THORNTON CO
80260-4830
US

IV. Provider business mailing address

737 S PRAIRIE DR
MILLIKEN CO
80543-3192
US

V. Phone/Fax

Practice location:
  • Phone: 720-272-1323
  • Fax:
Mailing address:
  • Phone: 720-272-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALMA SILVA GUTIERREZ
Title or Position: NP/OWNER
Credential: NP
Phone: 720-272-1323