Individual
EVANS TAMPUBOLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2500 S HAVANA ST, AURORA, CO 80014-1618
(303) 338-4545
Mailing address
19179 E 54TH PL, DENVER, CO 80249-8750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1642591
CO
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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