Healthcare Provider Details

I. General information

NPI: 1073872628
Provider Name (Legal Business Name): BRITTANY MCHELLE AMACKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 11/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3292 PEORIA ST
AURORA CO
80010-1517
US

IV. Provider business mailing address

3292 PEORIA ST
AURORA CO
80010-1517
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-6276
  • Fax:
Mailing address:
  • Phone: 303-360-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000179592
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA003745
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN 0991771 NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: