Provider Demographics
NPI:1003472549
Name:AVILA-HARDEE, DORIS
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:AVILA-HARDEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 S COUNTY ROAD 193
Mailing Address - Street 2:
Mailing Address - City:BYERS
Mailing Address - State:CO
Mailing Address - Zip Code:80103-9409
Mailing Address - Country:US
Mailing Address - Phone:303-819-9133
Mailing Address - Fax:
Practice Address - Street 1:2563 S COUNTY ROAD 193
Practice Address - Street 2:
Practice Address - City:BYERS
Practice Address - State:CO
Practice Address - Zip Code:80103-9409
Practice Address - Country:US
Practice Address - Phone:303-819-9133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 373H00000X
CO172A00000X, 372500000X, 372600000X, 376J00000X, 373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion