Individual
ALLISON MARIE MITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
5004792
NC
363LF0000X
Family Nurse Practitioner
Primary
64
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024331
KAISER COMMERCIAL NUMBER
CO
05
—
28506049
—
CO
Enumeration date
07/26/2010
Last updated
04/10/2014
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