Healthcare Provider Details

I. General information

NPI: 1386833242
Provider Name (Legal Business Name): ANGELO JOSEPH APODACA AGPCNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 17TH ST UNIT 2713
DENVER CO
80202-1508
US

IV. Provider business mailing address

1312 17TH ST UNIT 2713
DENVER CO
80202-1508
US

V. Phone/Fax

Practice location:
  • Phone: 720-818-7893
  • Fax: 720-815-0385
Mailing address:
  • Phone: 720-818-7893
  • Fax: 720-815-0385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0997836
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: