Healthcare Provider Details

I. General information

NPI: 1467446245
Provider Name (Legal Business Name): ANGELA MARIE ALDORETTA RN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MARIE NOVAK

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 N 7TH ST
GRAND JUNCTION CO
81501
US

IV. Provider business mailing address

PO BOX 62
GRAND JUNCTION CO
81502-0062
US

V. Phone/Fax

Practice location:
  • Phone: 970-244-6166
  • Fax: 970-255-1809
Mailing address:
  • Phone: 970-244-7050
  • Fax: 970-255-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number168504
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberNP4551
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: