Provider Demographics
NPI:1265324743
Name:TASHKULOV, SEVARA
Entity type:Individual
Prefix:
First Name:SEVARA
Middle Name:
Last Name:TASHKULOV
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 1:21595 E LAYTON LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6776
Mailing Address - Country:US
Mailing Address - Phone:720-469-6498
Mailing Address - Fax:
Practice Address - Street 1:21595 E LAYTON LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-6776
Practice Address - Country:US
Practice Address - Phone:720-469-6498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1663206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse