Healthcare Provider Details

I. General information

NPI: 1487567244
Provider Name (Legal Business Name): SITINA EDRIES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 S URAVAN ST
AURORA CO
80013-3422
US

IV. Provider business mailing address

3809 S URAVAN ST
AURORA CO
80013-3422
US

V. Phone/Fax

Practice location:
  • Phone: 720-278-0054
  • Fax:
Mailing address:
  • Phone: 720-278-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberS20125486-001
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: