Provider Demographics
NPI:1477126209
Name:LUGO, MICHELLE DENISE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENISE
Last Name:LUGO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-584-8900
Mailing Address - Fax:303-584-0525
Practice Address - Street 1:850 E HARVARD AVE STE 405
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5077
Practice Address - Country:US
Practice Address - Phone:303-584-8900
Practice Address - Fax:303-584-0525
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996715-NP207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine