Basic Information
Provider Information
NPI: 1033235643
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AYCRIGG
FirstName: ANN
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10350 E DAKOTA AVE
Address2:  
City: DENVER
State: CO
PostalCode: 802471314
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 EXEMPLA CIR
Address2:  
City: LAFAYETTE
State: CO
PostalCode: 800263370
CountryCode: US
TelephoneNumber: 3033384545
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2007
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X682COY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
208000000X89855CON Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
3828487105CO MEDICAID
01088701 KAISER-COMMERCIAL NUMBEROTHER


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