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General NPI Number Information
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NPI Number | 1477114890
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Entity Type | Individual
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Provider Name | AMANDA LEIGH VANCONANT CNP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 4704 HARLAN ST STE 340
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City | DENVER
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State | CO
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Zip | 80212-7418
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Country | US
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Telephone | 303-720-1845
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Fax | 303-479-4958
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Provider Business Mailing Address
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Address Line | 4704 HARLAN ST STE 340
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City | DENVER
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State | CO
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Zip | 80212-7418
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Country | US
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Telephone | 303-720-1845
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Fax | 303-479-4958
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.0176861
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0994796-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CP001868
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0102053
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License Number State | CO
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