Provider Demographics
NPI:1134945686
Name:BENDER, MARLO (FNP-C)
Entity type:Individual
Prefix:
First Name:MARLO
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24432 E TENNESSEE PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-6147
Mailing Address - Country:US
Mailing Address - Phone:505-480-1527
Mailing Address - Fax:
Practice Address - Street 1:1873 S BELLAIRE ST STE 620
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4353
Practice Address - Country:US
Practice Address - Phone:720-263-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN-0999763-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily