Provider Demographics
NPI:1144946575
Name:KUKUS, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KUKUS
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 1:1232 ALPINE PL
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2103
Mailing Address - Country:US
Mailing Address - Phone:970-217-7792
Mailing Address - Fax:
Practice Address - Street 1:8010 S COUNTY ROAD 5 UNIT 205
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-9004
Practice Address - Country:US
Practice Address - Phone:888-777-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0997782-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care