Healthcare Provider Details

I. General information

NPI: 1235004318
Provider Name (Legal Business Name): ROCKY MOUNTAIN CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S POTOMAC ST
AURORA CO
80012-5405
US

IV. Provider business mailing address

1700 S POTOMAC ST
AURORA CO
80012-5405
US

V. Phone/Fax

Practice location:
  • Phone: 303-418-7600
  • Fax: 303-750-3137
Mailing address:
  • Phone: 303-418-7600
  • Fax: 303-750-3137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAYLA NICHOLSON
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 408-642-4092