Provider Demographics
NPI:1801370663
Name:SPAAK, AMANDA J (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:SPAAK
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2404
Mailing Address - Fax:970-490-4340
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE STE 2200
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-203-7520
Practice Address - Fax:970-203-7256
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0994246-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner