Individual
MIRANDA ALEXANDER BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6380 PROMENADE PKWY, CASTLE ROCK, CO 80108-1909
(720) 734-1126
Mailing address
6380 PROMENADE PKWY, CASTLE ROCK, CO 80108-1909
(720) 734-1126
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
234893
SC
363L00000X
Nurse Practitioner
GAA-NP000506
GA
363LF0000X
Family Nurse Practitioner
Primary
C-APN.0106561
CO
363LF0000X
Family Nurse Practitioner
Primary
GAA-NP000506
GA
Other
Enumeration date
11/01/2021
Last updated
08/04/2026
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