Provider Demographics
NPI:1417724204
Name:TAKKEN, AMY MCCRACKEN (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MCCRACKEN
Last Name:TAKKEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MCCRACKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:844 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4810
Mailing Address - Country:US
Mailing Address - Phone:970-690-6341
Mailing Address - Fax:
Practice Address - Street 1:844 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4810
Practice Address - Country:US
Practice Address - Phone:970-690-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO113756163WG0600X, 163WH0200X, 163WH0500X, 163WP0200X, 163WW0000X, 163WX0003X, 163W00000X, 163WP0000X, 163WM0102X, 163WN0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk