=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972302545
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA JEAN BRAITHWOOD RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2025
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1700 WHEELING ST
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80045-7211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-399-8020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5765 PINE CT
-----------------------------------------------------
City | LARKSPUR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80118-9608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-524-4595
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0400X
-----------------------------------------------------
Taxonomy Name | Case Management Registered Nurse
-----------------------------------------------------
License Number | RN.1691366
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------