Provider Demographics
NPI:1013047950
Name:HOLSTEGE, MARCI J (NP)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:J
Last Name:HOLSTEGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARCI
Other - Middle Name:H
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:10350 E DAKOTA AVE
Practice Address - Street 2:STE B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1314
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO129118363L00000X
COAPN.0003598-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85325830Medicaid
015852OtherKAISER COMMERCIAL NUMBER
CO85325830Medicaid
COCOA104431Medicare PIN
COC804185Medicare PIN