Provider Demographics
NPI:1538791454
Name:STORHOLT, CONNIE NGUYEN (FNP-C)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:NGUYEN
Last Name:STORHOLT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 FOXTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9360
Mailing Address - Country:US
Mailing Address - Phone:970-495-0506
Mailing Address - Fax:970-795-0485
Practice Address - Street 1:1605 FOXTRAIL DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9360
Practice Address - Country:US
Practice Address - Phone:970-495-0506
Practice Address - Fax:970-495-0485
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF11190448363LF0000X
COAPN.0998071363LF0000X
NC5012857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily