MEDICARE: AMANDA DENISE JARVENPAA FNP

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	363LF0000X	Family Nurse Practitioner	APN.0997318-NP	CO

General Provider Information

NPI Number	:	1962156158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DENISE JARVENPAA FNP

Provider Business Mailing Address
First Line	:	10977 HIDDEN PRAIRIE PKWY
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-7211
Country	:	US
Telephone Number	:	719-472-4384
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR BLDG 7503
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-526-7653
Fax Number	:

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

Provider Enumeration Date	:	02/07/2022
Last Update Date	:	04/15/2026

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