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General NPI Number Information
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NPI Number | 1770513400
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Entity Type | Organization
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Legal Business Name | RENAL NURSE ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1440 VINE ST
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City | DENVER
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State | CO
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Zip | 80206-2016
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Country | US
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Telephone | 303-355-5644
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Fax | 303-355-5059
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Provider Business Mailing Address
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Address Line | 8340 EVERETT WAY
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City | ARVADA
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State | CO
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Zip | 80005-2211
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Country | US
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Telephone | 303-355-5644
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Fax | 303-355-5059
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MS. SHARON LYNN ANTONELLI
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Credential | RN, CNN, CEO
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Telephone | 303-355-5644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 0997
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License Number State | CO
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