Provider Demographics
NPI:1669815304
Name:HUDDLE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HUDDLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9731 W 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2016
Mailing Address - Country:US
Mailing Address - Phone:303-421-1200
Mailing Address - Fax:303-403-2881
Practice Address - Street 1:9731 W 58TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2016
Practice Address - Country:US
Practice Address - Phone:303-421-1200
Practice Address - Fax:303-403-2881
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist