Healthcare Provider Details

I. General information

NPI: 1326714171
Provider Name (Legal Business Name): ANTHONY ESQUIVEL AGPCNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANTHONY ESQUIVEL MONDRAGON AGPCNP

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax: 303-602-4560
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-602-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN.0996519-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN.0996519-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: