Healthcare Provider Details

I. General information

NPI: 1013631688
Provider Name (Legal Business Name): ASHA ANNAH RIZZO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 MITCHELL WAY STE 103
ERIE CO
80516-5443
US

IV. Provider business mailing address

80 HEALTH PARK DR STE 270
LOUISVILLE CO
80027-4644
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-4108
  • Fax: 303-269-2790
Mailing address:
  • Phone: 303-649-3180
  • Fax: 303-269-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0998046-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: