NPI 1104707587 · Nurse Practitioner - Family · Anthem
Moderate evidence supports active practice with 1 carrier network listing and verified licensure.
NPPES
LAKEWOOD, 80227
Freshness: Unknown
Network Status
Listed with 1 carrier
DORA License
Active - Provisional
Medicare
Not enrolled in Medicare (PECOS)
Care Compare
Address mismatch with NPPES
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
Active Colorado DORA license confirmed
Found in carrier FHIR directory
Single address source (NPPES)
Weak network corroboration
1 network across 1 carrier
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.