Provider Demographics
NPI:1164016507
Name:KAPHLE TRIPATHI, SHARADA
Entity Type:Individual
Prefix:
First Name:SHARADA
Middle Name:
Last Name:KAPHLE TRIPATHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9195 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4385
Mailing Address - Country:US
Mailing Address - Phone:720-638-5474
Mailing Address - Fax:
Practice Address - Street 1:9195 GRANT ST STE 305
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:720-638-5474
Practice Address - Fax:303-955-0179
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996159225000000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter