Provider Demographics
NPI:1063200053
Name:VIDA PLENA WELLNESS
Entity type:Organization
Organization Name:VIDA PLENA WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:720-272-1323
Mailing Address - Street 1:737 S PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-3192
Mailing Address - Country:US
Mailing Address - Phone:720-272-3123
Mailing Address - Fax:
Practice Address - Street 1:81 W 84TH AVE STE 180
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4830
Practice Address - Country:US
Practice Address - Phone:720-272-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty