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Individual

LISA LEILANI VAN TINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP,CNS

Contact information

Practice address
3292 PEORIA ST, AURORA, CO 80010-1517
(303) 343-6130
(303) 344-0664
Mailing address
3701 S BROADWAY, ENGLEWOOD, CO 80113-3611
(303) 761-1977
(303) 761-2787

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.0127666
CO
363L00000X
Nurse Practitioner
RXN.0006301-NP
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
APN.0004136-NP
CO

Other

Enumeration date
08/23/2006
Last updated
01/16/2019
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