Healthcare Provider Details

I. General information

NPI: 1861235400
Provider Name (Legal Business Name): MAVIS OWUSU RN,MSN, APRN,FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAVIS GYAU-ANING BSC.

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 S POTOMAC ST STE 320
AURORA CO
80012-4512
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 303-894-7800
  • Fax:
Mailing address:
  • Phone: 719-463-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999835-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: