Healthcare Provider Details

I. General information

NPI: 1669380150
Provider Name (Legal Business Name): YAMOUDJI KONE DIARRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MADISON ST STE 704
DENVER CO
80206-5416
US

IV. Provider business mailing address

90 MADISON ST STE 704
DENVER CO
80206-5416
US

V. Phone/Fax

Practice location:
  • Phone: 303-951-6253
  • Fax: 623-321-6050
Mailing address:
  • Phone: 303-951-6253
  • Fax: 623-321-6050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1002349-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: