Healthcare Provider Details

I. General information

NPI: 1053162461
Provider Name (Legal Business Name): AMARLEY AMARTEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 W COLFAX AVE
LAKEWOOD CO
80215-3733
US

IV. Provider business mailing address

12600 W COLFAX AVE STE B200
LAKEWOOD CO
80215-3736
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-1330
  • Fax:
Mailing address:
  • Phone: 303-993-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999530-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: