Provider Demographics
NPI:1235004318
Name:ROCKY MOUNTAIN CANCER CENTER
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:408-642-4092
Mailing Address - Street 1:1700 S POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5405
Mailing Address - Country:US
Mailing Address - Phone:303-418-7600
Mailing Address - Fax:303-750-3137
Practice Address - Street 1:1700 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5405
Practice Address - Country:US
Practice Address - Phone:303-418-7600
Practice Address - Fax:303-750-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology