Provider Demographics
NPI:1194841163
Name:RICHARDS, DENNIS W (ANP)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:W
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 HAPGOOD ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6966
Mailing Address - Country:US
Mailing Address - Phone:303-449-7298
Mailing Address - Fax:
Practice Address - Street 1:WARDENBURG HEALTH CTR
Practice Address - Street 2:BOX 119
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-0119
Practice Address - Country:US
Practice Address - Phone:303-492-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO66969363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health