Healthcare Provider Details

I. General information

NPI: 1720330889
Provider Name (Legal Business Name): ELIZABETH ANN WESTMARK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 S PARKER RD STE 100
AURORA CO
80014-2914
US

IV. Provider business mailing address

3025 S PARKER RD STE 100
AURORA CO
80014-2914
US

V. Phone/Fax

Practice location:
  • Phone: 303-481-7030
  • Fax: 303-745-7935
Mailing address:
  • Phone: 303-481-7030
  • Fax: 303-745-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0178390
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0990387-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: