Provider Demographics
NPI:1568088409
Name:PONTIERO, MARIA SUZETTE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SUZETTE
Last Name:PONTIERO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 INDIANA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5012
Mailing Address - Country:US
Mailing Address - Phone:303-736-9697
Mailing Address - Fax:720-306-5464
Practice Address - Street 1:430 INDIANA ST STE 100
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5012
Practice Address - Country:US
Practice Address - Phone:303-736-9697
Practice Address - Fax:720-306-5464
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996737363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health