Provider Demographics
NPI:1821246836
Name:BURKHALTER, ALISA COLEEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:COLEEN
Last Name:BURKHALTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E HAMPDEN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2517
Mailing Address - Country:US
Mailing Address - Phone:303-789-4968
Mailing Address - Fax:
Practice Address - Street 1:180 E HAMPDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2517
Practice Address - Country:US
Practice Address - Phone:303-789-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO160383363LF0000X
CO5333363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88803074Medicaid
CO88803074Medicaid
COCO307085Medicare PIN