Individual
SOUNANTHA SAYAVONGSA HARNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2355 W 136TH AVE, BROOMFIELD, CO 80023-9331
(303) 658-9827
Mailing address
3349 W 37TH AVE, DENVER, CO 80211-2717
(269) 208-1759
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0993323
CO
Other
Enumeration date
01/31/2018
Last updated
06/30/2021
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