Provider Demographics
NPI:1265692776
Name:O'CONNOR, TARA GENE (FNP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:GENE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-788-8355
Mailing Address - Fax:303-788-4448
Practice Address - Street 1:799 E HAMPDEN AVE STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2762
Practice Address - Country:US
Practice Address - Phone:303-788-6490
Practice Address - Fax:303-788-5451
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2022-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CORN-163779163WG0000X
CONP5752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23109777Medicaid
CO530564YL7XMedicare PIN