Provider Demographics
NPI:1598333569
Name:MAMO, TSION TONA
Entity Type:Individual
Prefix:
First Name:TSION
Middle Name:TONA
Last Name:MAMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 S LANSING ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2207
Mailing Address - Country:US
Mailing Address - Phone:720-327-9967
Mailing Address - Fax:303-994-6503
Practice Address - Street 1:445 S LANSING ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2207
Practice Address - Country:US
Practice Address - Phone:720-327-9967
Practice Address - Fax:303-994-6503
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0996385-CNS364SH0200X
COAPN.09963585-CNS364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health