Healthcare Provider Details

I. General information

NPI: 1407221518
Provider Name (Legal Business Name): DENA LEWIS DNP, APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MOORES CANYON RD STE 4
TRINIDAD CO
81082-8554
US

IV. Provider business mailing address

19313 PONDEROSA DR
WESTON CO
81091-9742
US

V. Phone/Fax

Practice location:
  • Phone: 719-752-0250
  • Fax:
Mailing address:
  • Phone: 304-261-6204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024177427
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0996448-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number61048
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN67066-AGACNP-BC
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: