Healthcare Provider Details

I. General information

NPI: 1568686137
Provider Name (Legal Business Name): TATYANA PLOTKIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 E EVANS AVE STE 102
DENVER CO
80224-2300
US

IV. Provider business mailing address

1454 S UINTA CT
DENVER CO
80231-2742
US

V. Phone/Fax

Practice location:
  • Phone: 303-691-5009
  • Fax: 303-691-8897
Mailing address:
  • Phone: 303-807-5021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15733
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN.0999138.NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: