MEDICARE: MICHELLE MARIE EDWARDS RN, AGACNP-BC

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.0995077-NP	CO
2	163W00000X	Registered Nurse	RN.0165267	CO

General Provider Information

NPI Number	:	1366875841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARIE EDWARDS RN, AGACNP-BC

Provider Business Mailing Address
First Line	:	9351 GRANT ST STE 490
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80229-4365
Country	:	US
Telephone Number	:	303-844-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9351 GRANT ST STE 490
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80229-4365
Country	:	US
Telephone Number	:	303-844-5000
Fax Number	:

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

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	10/19/2025

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