Provider Demographics
NPI:1417393174
Name:BROWN, AMANDA RENAE (RN, RNFA, APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:RENAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, RNFA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 6400
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-839-7200
Mailing Address - Fax:303-839-7229
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 6400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-839-7200
Practice Address - Fax:303-839-7229
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO172908163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO172908OtherCOLORADO RN LICENSE