Basic Information
Provider Information
NPI: 1598306623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAU
FirstName: MINNIE
MiddleName: NGUYEN
NamePrefix: MRS.
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12605 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208481980
FaxNumber:  
Practice Location
Address1: 12605 E 16TH AVE FL 1
Address2:  
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208481980
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/30/2019
LastUpdateDate: 03/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XAPN.0994922-NPCOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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