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General NPI Number Information
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NPI Number | 1316365026
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Entity Type | Individual
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Provider Name | AUDRA VERONICA DICARO M.M.SC.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 13952 DENVER WEST PKWY BUILDING 53 #100
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City | LAKEWOOD
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State | CO
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Zip | 80401-3141
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Country | US
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Telephone | 303-604-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 382 S ARTHUR AVE
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City | LOUISVILLE
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State | CO
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Zip | 80027-3094
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Country | US
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Telephone | 303-604-5000
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Fax | 720-890-0364
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0004735
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License Number State | CO
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