Individual
MRS. AMANDA C FADENRECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
141 S PURCELL BLVD STE 140, PUEBLO WEST, CO 81007-5123
(719) 281-9587
(855) 593-6512
Mailing address
141 S PURCELL BLVD STE 140, PUEBLO WEST, CO 81007-5123
(719) 281-9587
(855) 593-6512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN0991259NP
CO
363LP2300X
Primary Care Nurse Practitioner
Primary
APN-0991259
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN0991259NP
STATE LICENSE
CO
Enumeration date
07/18/2014
Last updated
02/12/2021
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