Healthcare Provider Details

I. General information

NPI: 1033082201
Provider Name (Legal Business Name): EMILY SPICA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 3RD ST SE
LOVELAND CO
80537-6419
US

IV. Provider business mailing address

2900 QUERIDA ST
FORT COLLINS CO
80526-3742
US

V. Phone/Fax

Practice location:
  • Phone: 970-669-4855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001223-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: