Provider Demographics
NPI:1316558406
Name:BEARD, AMANDA NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:BEARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 UPHAM ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4800
Mailing Address - Country:US
Mailing Address - Phone:303-742-0086
Mailing Address - Fax:720-221-8994
Practice Address - Street 1:3885 UPHAM ST STE 100
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4800
Practice Address - Country:US
Practice Address - Phone:303-742-0086
Practice Address - Fax:720-221-8994
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995823-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner