Provider Demographics
NPI:1407235435
Name:REGIS NEIGHBORHOOD HEALTH
Entity Type:Organization
Organization Name:REGIS NEIGHBORHOOD HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNFEE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:303-870-3214
Mailing Address - Street 1:3333 REGIS BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221
Mailing Address - Country:US
Mailing Address - Phone:303-870-3214
Mailing Address - Fax:
Practice Address - Street 1:3333 REGIS BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1154
Practice Address - Country:US
Practice Address - Phone:303-870-3214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0177655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty