Provider Demographics
NPI:1801461876
Name:BROUS, CHELSEA RIVA (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RIVA
Last Name:BROUS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 HURON ST APT 520
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1053
Mailing Address - Country:US
Mailing Address - Phone:607-227-0424
Mailing Address - Fax:
Practice Address - Street 1:13650 E MISSISSIPPI AVE STE 100B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3573
Practice Address - Country:US
Practice Address - Phone:303-695-1338
Practice Address - Fax:303-695-8814
Is Sole Proprietor?:No
Enumeration Date:2021-05-23
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily