Healthcare Provider Details

I. General information

NPI: 1659986461
Provider Name (Legal Business Name): AMANDA K HARRISON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BRIARGATE PKWY STE 100B
COLORADO SPRINGS CO
80920-7836
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-0160
  • Fax: 719-364-0161
Mailing address:
  • Phone: 719-364-0160
  • Fax: 719-364-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0995835
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: