Provider Demographics
NPI:1811916059
Name:MAIN, MARIA ANA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANA
Last Name:MAIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANA
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:970-495-8440
Mailing Address - Fax:970-495-7644
Practice Address - Street 1:1024 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3929
Practice Address - Country:US
Practice Address - Phone:970-495-8440
Practice Address - Fax:970-495-7644
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9163562363LP2300X
COAPN.0990042-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3077641-00Medicaid
FLU8881ZMedicare PIN
FLQ73709Medicare UPIN