Provider Demographics
NPI:1669893061
Name:NIFFENEGGER, ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:NIFFENEGGER
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:KELLOGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:6200 E CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7013
Mailing Address - Country:US
Mailing Address - Phone:303-902-3462
Mailing Address - Fax:
Practice Address - Street 1:6200 E CORNELL AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7013
Practice Address - Country:US
Practice Address - Phone:303-902-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62982834Medicaid