Provider Demographics
NPI:1063965051
Name:BRAEGGER, DENISE (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BRAEGGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ELIZABETH
Other - Last Name:FENNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23943 BROADMOOR PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3158
Mailing Address - Country:US
Mailing Address - Phone:612-998-7261
Mailing Address - Fax:
Practice Address - Street 1:9285 HEPBURN ST
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2262
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0169139261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care