Healthcare Provider Details

I. General information

NPI: 1306464383
Provider Name (Legal Business Name): BROOKLYN NICOLE HUGHES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14190 ORCHARD PKWY STE 250
WESTMINSTER CO
80023-9708
US

IV. Provider business mailing address

14190 ORCHARD PKWY STE 250
WESTMINSTER CO
80023-9708
US

V. Phone/Fax

Practice location:
  • Phone: 720-497-6666
  • Fax: 720-497-6777
Mailing address:
  • Phone: 720-497-6666
  • Fax: 720-497-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31325
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17198
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: