Healthcare Provider Details

I. General information

NPI: 1841199221
Provider Name (Legal Business Name): TANANYA DUARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5495 ARAPAHOE AVE STE 100
BOULDER CO
80303-1224
US

IV. Provider business mailing address

5495 ARAPAHOE AVE STE 100
BOULDER CO
80303-1224
US

V. Phone/Fax

Practice location:
  • Phone: 303-415-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN.1693462
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: