Healthcare Provider Details

I. General information

NPI: 1306667431
Provider Name (Legal Business Name): MRS. AMBER COVINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 LEWIS AVE
LA JUNTA CO
81050-1738
US

IV. Provider business mailing address

PO BOX 408
LA JUNTA CO
81050-0408
US

V. Phone/Fax

Practice location:
  • Phone: 719-384-8827
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1640725
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001363-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: