Provider Demographics
NPI:1629209978
Name:ESTERGARD, AMY JORDAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JORDAN
Last Name:ESTERGARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9125
Mailing Address - Country:US
Mailing Address - Phone:970-397-5826
Mailing Address - Fax:
Practice Address - Street 1:6455 S YOSEMITE ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5139
Practice Address - Country:US
Practice Address - Phone:303-718-2956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily