Healthcare Provider Details

I. General information

NPI: 1255255600
Provider Name (Legal Business Name): AMANDA R BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 INDIANA AVE STE C
PUEBLO CO
81004-3767
US

IV. Provider business mailing address

7264 PEACHLEAF DR
COLORADO SPRINGS CO
80925-9499
US

V. Phone/Fax

Practice location:
  • Phone: 719-568-8611
  • Fax:
Mailing address:
  • Phone: 720-935-4145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002285-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: