Healthcare Provider Details

I. General information

NPI: 1366823916
Provider Name (Legal Business Name): CHERI ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIKE ADAMS

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5240 LA COSTA DR
ELIZABETH CO
80107-9107
US

IV. Provider business mailing address

5240 LA COSTA DR
ELIZABETH CO
80107-9107
US

V. Phone/Fax

Practice location:
  • Phone: 303-921-6136
  • Fax:
Mailing address:
  • Phone: 303-921-6136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number343261
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: