Provider Demographics
NPI:1609536440
Name:LAUBHAN, CALYPSO NICOLE (CPNP-AC, RN)
Entity type:Individual
Prefix:
First Name:CALYPSO
Middle Name:NICOLE
Last Name:LAUBHAN
Suffix:
Gender:F
Credentials:CPNP-AC, RN
Other - Prefix:
Other - First Name:CALYPSO
Other - Middle Name:NICOLE
Other - Last Name:GRUBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2652 S QUITMAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5724
Mailing Address - Country:US
Mailing Address - Phone:303-525-1376
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2170
Practice Address - Fax:206-987-3866
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61247701363LP0200X, 363LP0222X, 363LA2100X
WA61250730363LP0200X, 363LA2100X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care