Provider Demographics
NPI:1063752673
Name:WATERS, LAURA K (NP)
Entity type:Individual
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First Name:LAURA
Middle Name:K
Last Name:WATERS
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Gender:F
Credentials:NP
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-320-8499
Mailing Address - Fax:303-320-8620
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:SUITE 470
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3912
Practice Address - Country:US
Practice Address - Phone:303-320-8499
Practice Address - Fax:303-320-8620
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2022-01-27
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Provider Licenses
StateLicense IDTaxonomies
CO0990647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60332344Medicaid
CO60332344Medicaid