Healthcare Provider Details

I. General information

NPI: 1588590822
Provider Name (Legal Business Name): MARC AMEY CNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 S EMERY ST UNIT B
LONGMONT CO
80501-8973
US

IV. Provider business mailing address

1212 S EMERY ST UNIT B
LONGMONT CO
80501-8973
US

V. Phone/Fax

Practice location:
  • Phone: 303-667-8306
  • Fax:
Mailing address:
  • Phone: 303-667-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA.00820128
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: