Healthcare Provider Details

I. General information

NPI: 1972968873
Provider Name (Legal Business Name): MINA TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2015
Last Update Date: 12/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2042 S PASEO WAY
DENVER CO
80219-5241
US

IV. Provider business mailing address

2042 S PASEO WAY
DENVER CO
80219-5241
US

V. Phone/Fax

Practice location:
  • Phone: 720-939-3653
  • Fax:
Mailing address:
  • Phone: 303-937-6808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1617712
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: