Provider Demographics
NPI:1912659863
Name:THEISS, ARIANNE (PHD)
Entity Type:Individual
Prefix:
First Name:ARIANNE
Middle Name:
Last Name:THEISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ARIANNE
Other - Middle Name:
Other - Last Name:GOODRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8635 E 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2553
Mailing Address - Country:US
Mailing Address - Phone:404-345-7708
Mailing Address - Fax:
Practice Address - Street 1:12700 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2560
Practice Address - Country:US
Practice Address - Phone:303-724-7254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch