Provider Demographics
NPI:1396387692
Name:MARPAUNG, ESTER SULISTIOWATI (RN)
Entity Type:Individual
Prefix:
First Name:ESTER
Middle Name:SULISTIOWATI
Last Name:MARPAUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17280 E TENNESSEE DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3266
Mailing Address - Country:US
Mailing Address - Phone:720-609-3580
Mailing Address - Fax:
Practice Address - Street 1:17280 E TENNESSEE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3266
Practice Address - Country:US
Practice Address - Phone:720-609-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1617593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse