Provider Demographics
NPI:1215679139
Name:HENRIKSEN, BRITTANY M (CPNP-PC, RN, BSN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:M
Last Name:HENRIKSEN
Suffix:
Gender:F
Credentials:CPNP-PC, RN, BSN
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:825 W 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80260-5603
Mailing Address - Country:US
Mailing Address - Phone:360-929-0301
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997958-NP363LP0200X
CO1646941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1646941OtherREGISTERED NURSE LICENSE NUMBER
COAPN.0997958-NPOtherADVANCED PRACTICE NURSE PRACTITIONER LICENSE NUMBER