Healthcare Provider Details

I. General information

NPI: 1063101517
Provider Name (Legal Business Name): ARIELLE MIRAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 S SYCAMORE ST
LITTLETON CO
80120-1132
US

IV. Provider business mailing address

116 INVERNESS DR E STE 105
ENGLEWOOD CO
80112-5125
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8858
  • Fax:
Mailing address:
  • Phone: 303-730-8858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1689220
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number1689220
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: