Provider Demographics
NPI:1558021592
Name:LOPEZ, COLLEEN MARIE (NP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 E COLUMBIA PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4132
Mailing Address - Country:US
Mailing Address - Phone:813-447-0642
Mailing Address - Fax:
Practice Address - Street 1:4704 HARLAN ST STE 340
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-7418
Practice Address - Country:US
Practice Address - Phone:303-720-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1672574163W00000X
CO1000542363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse