Provider Demographics
NPI:1093136996
Name:ENRIQUEZ, GLORIA LILIANA (FNP)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:LILIANA
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8671 S QUEBEC ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5859
Mailing Address - Country:US
Mailing Address - Phone:888-852-6672
Mailing Address - Fax:
Practice Address - Street 1:7353 SISTERS GRV
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2615
Practice Address - Country:US
Practice Address - Phone:334-710-9088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991405-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily