Healthcare Provider Details

I. General information

NPI: 1972302545
Provider Name (Legal Business Name): ANGELA JEAN BRAITHWOOD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

5765 PINE CT
LARKSPUR CO
80118-9608
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax:
Mailing address:
  • Phone: 720-524-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN.1691366
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: