Healthcare Provider Details

I. General information

NPI: 1063002806
Provider Name (Legal Business Name): ELIZABETH DIEGO PASTRANA REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16776 E LOUISIANA DR
AURORA CO
80017-4106
US

IV. Provider business mailing address

16776 E LOUISIANA DR
AURORA CO
80017-4106
US

V. Phone/Fax

Practice location:
  • Phone: 720-210-2724
  • Fax:
Mailing address:
  • Phone: 720-210-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0334399
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number1703325
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1703325
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: