Provider Demographics
NPI:1669042347
Name:CHECKLEY, THOMAS (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CHECKLEY
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 BROADWAY STE 1350
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5146
Mailing Address - Country:US
Mailing Address - Phone:512-921-9374
Mailing Address - Fax:
Practice Address - Street 1:1560 BROADWAY STE 1350
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-5146
Practice Address - Country:US
Practice Address - Phone:512-921-9374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1645444163W00000X
COAPN.0996974-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse