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General NPI Number Information
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NPI Number | 1275102873
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Entity Type | Individual
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Provider Name | EMILY SISA
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 10450 PARK MEADOWS DR
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City | LONE TREE
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State | CO
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Zip | 80124-5529
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Country | US
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Telephone | 720-707-6914
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 IVY ST
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City | DENVER
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State | CO
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Zip | 80207-1242
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Country | US
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Telephone | 703-403-5665
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0003040-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0996677
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License Number State | CO
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