Provider Demographics
NPI:1568078707
Name:VAUSE, WILLIAM GLENN (NP-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GLENN
Last Name:VAUSE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 S IOLA ST APT 107
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4087
Mailing Address - Country:US
Mailing Address - Phone:303-949-0632
Mailing Address - Fax:
Practice Address - Street 1:5200 DTC PKWY STE 400
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2719
Practice Address - Country:US
Practice Address - Phone:303-745-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995876-NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care