MEDICARE: AMY EILEEN VALESH-PETERSON MSN

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	363LC1500X	Community Health Nurse Practitioner	A104321	IA
2	363LF0000X	Family Nurse Practitioner	A-104321	IA
3	363L00000X	Nurse Practitioner	APN.0994110-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881688489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY EILEEN VALESH-PETERSON MSN

Provider Business Mailing Address
First Line	:	2970 ARAPAHOE RD
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-8054
Country	:	US
Telephone Number	:	303-460-6020
Fax Number	:	303-460-6021

Provider Business Practice Location Address
First Line	:	2970 ARAPAHOE RD
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-8054
Country	:	US
Telephone Number	:	303-460-6020
Fax Number	:	303-460-6021

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	11/01/2023

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