MEDICARE: IRINA K SUYUMOVA NURSE PRACTITIONER

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	APN.0994021-NP	CO

General Provider Information

NPI Number	:	1306324363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRINA K SUYUMOVA NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	13901 E EXPOSITION AVE STE 202
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-2552
Country	:	US
Telephone Number	:	303-327-4700
Fax Number	:	303-327-4711

Provider Business Practice Location Address
First Line	:	919 JASMINE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-4588
Country	:	US
Telephone Number	:	303-991-0993
Fax Number	:	303-531-6583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	01/21/2026

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