Provider Demographics
NPI:1013632579
Name:MENDOLLA, EMILY LINDSAY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LINDSAY
Last Name:MENDOLLA
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 1:3989 E ARAPAHOE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2077
Mailing Address - Country:US
Mailing Address - Phone:720-379-7243
Mailing Address - Fax:
Practice Address - Street 1:3989 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2092
Practice Address - Country:US
Practice Address - Phone:720-379-7243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32753363LF0000X
COAPN.0998111-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily