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General NPI Number Information
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NPI Number | 1376642363
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Entity Type | Organization
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Legal Business Name | SUNRISE FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 10268 W CENTENNIAL RD STE 104
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City | LITTLETON
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State | CO
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Zip | 80127
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Country | US
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Telephone | 303-738-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 10268 W CENTENNIAL RD STE 104
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City | LITTLETON
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State | CO
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Zip | 80127
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Country | US
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Telephone | 303-738-5808
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. NICOLE ELAINE HOFFMAN
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Credential | DO
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Telephone | 303-738-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41131
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License Number State | CO
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