MEDICARE: REGENTS OF THE UNIVERSITY OF COLORADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1174929939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIVERSITY OF COLORADO

Provider Business Mailing Address
First Line	:	13120 E 19TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2567
Country	:	US
Telephone Number	:	303-724-1812
Fax Number	:

Provider Business Practice Location Address
First Line	:	13120 E 19TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2567
Country	:	US
Telephone Number	:	303-724-1812
Fax Number	:

Authorized Official
Title or Position	:	DEAN
Name	:	DR. SARAH THOMPSON
Credential	:	PH.D., R.N., F.A.A.N
Telephone Number	:	303-724-1679

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	07/11/2017

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Practice Location Address:

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1134700016 — WARREN CHARLES STOPAK
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Directions to “REGENTS OF THE UNIVERSITY OF COLORADO ” Practice Location

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