Provider Demographics
NPI:1154465938
Name:BUSCH, COLLEEN M (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:BUSCH
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2251
Mailing Address - Country:US
Mailing Address - Phone:303-357-2559
Mailing Address - Fax:
Practice Address - Street 1:4700 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-584-8900
Practice Address - Fax:303-584-0525
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0069813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18984OtherID