Healthcare Provider Details

I. General information

NPI: 1073381497
Provider Name (Legal Business Name): ANGELA N ESCALERA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 COSTILLO CT
BRIGHTON CO
80601-6562
US

IV. Provider business mailing address

3946 COSTILLO CT
BRIGHTON CO
80601-6562
US

V. Phone/Fax

Practice location:
  • Phone: 720-470-5436
  • Fax:
Mailing address:
  • Phone: 720-470-5436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1656182
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: