Basic Information
Provider Information
NPI: 1700363538
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOYARS
FirstName: DENISE
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: NURSE'S AIDE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10101 WASHINGTON ST APT C110
Address2:  
City: THORNTON
State: CO
PostalCode: 802292015
CountryCode: US
TelephoneNumber: 3035898293
FaxNumber:  
Practice Location
Address1: 2460 W 26TH AVE STE 217
Address2:  
City: DENVER
State: CO
PostalCode: 802115308
CountryCode: US
TelephoneNumber: 3033227108
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2018
LastUpdateDate: 07/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
376K00000XNA.00783840COY Nursing Service Related ProvidersNurse's Aide 

No ID Information.


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