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Individual

MRS. AMANDA GAIL HEINRICHS TYACKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4600 HALE PKWY, SUITE 400, DENVER, CO 80220-4020
(303) 280-0900
(303) 280-3858
Mailing address
5433 S VERSAILLES ST, AURORA, CO 80015-6526
(720) 876-1171
(303) 280-3858

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
111324
CO

Other

Enumeration date
06/05/2007
Last updated
07/08/2007
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