Healthcare Provider Details

I. General information

NPI: 1598333569
Provider Name (Legal Business Name): TSION TONA MAMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 12/26/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 S LANSING ST
AURORA CO
80012-2207
US

IV. Provider business mailing address

445 S LANSING ST
AURORA CO
80012-2207
US

V. Phone/Fax

Practice location:
  • Phone: 720-327-9967
  • Fax: 303-994-6503
Mailing address:
  • Phone: 720-327-9967
  • Fax: 303-994-6503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License NumberAPN0996385-CNS
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAPN.09963585-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: