Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APN.0994110-NP | CO |
N | 363LC1500X | Nurse Practitioner - Community Health | A104321 | IA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | A-104321 | IA |
NPI | 1881688489 |
---|---|
Provider Name | Amy Eileen Valesh-Peterson |
First Address | Westminster, CO 80234-3006 |
Second Address | Denver, CO 80219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 07/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2430835 | (05) | IA |
Q11363 | (02) |