Healthcare Provider Details

I. General information

NPI: 1689380990
Provider Name (Legal Business Name): UYEN THANH ADAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 N LAFAYETTE ST
DENVER CO
80205-3316
US

IV. Provider business mailing address

1154 ASPEN ST
BROOMFIELD CO
80020-1436
US

V. Phone/Fax

Practice location:
  • Phone: 303-500-1518
  • Fax:
Mailing address:
  • Phone: 720-323-5189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0998354
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: