Healthcare Provider Details

I. General information

NPI: 1518414267
Provider Name (Legal Business Name): MARIVEL MARTINEZ CUEVAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8990 WASHINGTON ST
THORNTON CO
80229-4537
US

IV. Provider business mailing address

1735 S PUBLIC RD STE 203
LAFAYETTE CO
80026-7093
US

V. Phone/Fax

Practice location:
  • Phone: 720-929-1655
  • Fax: 720-565-4129
Mailing address:
  • Phone: 303-665-3036
  • Fax: 303-665-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1640721
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN0998355NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0998355-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: