Basic Information
Provider Information
NPI: 1538458963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUFF
FirstName: LAURA
MiddleName: STURGESS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1056 S 88TH ST
Address2:  
City: LOUISVILLE
State: CO
PostalCode: 800279460
CountryCode: US
TelephoneNumber: 3034426647
FaxNumber: 3034422696
Practice Location
Address1: 2880 FOLSOM ST STE 200
Address2:  
City: BOULDER
State: CO
PostalCode: 80304
CountryCode: US
TelephoneNumber: 3034426647
FaxNumber: 3034422696
Other Information
ProviderEnumerationDate: 04/06/2011
LastUpdateDate: 06/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X60323COY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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