Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | CNP-02455 | NM |
N | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9217836 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | CNP-02455 | NM |
Y | 363LG0600X | Nurse Practitioner - Gerontology | APN.991183-NP | CO |
NPI | 1578796355 |
---|---|
Provider Name | Mr. Hernando A Mispireta |
First Address | Denver, CO 80230-7030 |
Second Address | Thornton, CO 80241-2402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | CO |