Provider Demographics
NPI:1225178064
Name:ROMERO, MICHAELA C (MSN,C-ANP)
Entity Type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:C
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MSN,C-ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 FIRESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6607
Mailing Address - Country:US
Mailing Address - Phone:720-652-7055
Mailing Address - Fax:720-652-7056
Practice Address - Street 1:5965 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-6607
Practice Address - Country:US
Practice Address - Phone:720-652-7055
Practice Address - Fax:720-652-7056
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0084086163W00000X
COAPN.0002125-NP363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000170625Medicaid