Provider Demographics
NPI:1073598595
Name:DRENTH, HARMA A (FNP)
Entity Type:Individual
Prefix:
First Name:HARMA
Middle Name:A
Last Name:DRENTH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HARMINA
Other - Middle Name:A
Other - Last Name:DRENTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5450 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2709
Mailing Address - Country:US
Mailing Address - Phone:303-415-4770
Mailing Address - Fax:303-415-4769
Practice Address - Street 1:3 SUPERIOR DR STE 100A
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8653
Practice Address - Country:US
Practice Address - Phone:303-415-5255
Practice Address - Fax:303-415-5256
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003155-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q23542Medicare UPIN
CO548818Medicare ID - Type Unspecified