Provider Demographics
NPI:1417921396
Name:AMARANTO, MARIAN (NP)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:AMARANTO
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 1:183 S 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-2472
Mailing Address - Country:US
Mailing Address - Phone:303-659-4248
Mailing Address - Fax:303-659-4283
Practice Address - Street 1:183 S 18TH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2472
Practice Address - Country:US
Practice Address - Phone:303-659-4248
Practice Address - Fax:303-659-4283
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN048289363LP0200X
CO40463363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics