Healthcare Provider Details

I. General information

NPI: 1063378693
Provider Name (Legal Business Name): ANNA LARIONOVA MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10555 E DARTMOUTH AVE STE 210
AURORA CO
80014-2633
US

IV. Provider business mailing address

PO BOX 461223
AURORA CO
80046-1223
US

V. Phone/Fax

Practice location:
  • Phone: 303-525-0717
  • Fax:
Mailing address:
  • Phone: 303-525-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANNA LARIONOVA
Title or Position: PHYSICIAN
Credential: MD
Phone: 303-525-0717