Provider Demographics
NPI:1356225031
Name:ST. DENIS, AUDREY MICHELLE
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:MICHELLE
Last Name:ST. DENIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 ELGIN CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-6434
Mailing Address - Country:US
Mailing Address - Phone:970-556-3101
Mailing Address - Fax:
Practice Address - Street 1:4401 UNION ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-2800
Practice Address - Country:US
Practice Address - Phone:970-619-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1000589-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner