Provider Demographics
NPI:1831391481
Name:OVIEDO, ARLEEN MUMAR (NP)
Entity type:Individual
Prefix:
First Name:ARLEEN
Middle Name:MUMAR
Last Name:OVIEDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ARLEEN
Other - Middle Name:
Other - Last Name:MUMAR-OVIEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4608 W 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2009
Mailing Address - Country:US
Mailing Address - Phone:303-379-9371
Mailing Address - Fax:303-284-4082
Practice Address - Street 1:4608 W 36TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2009
Practice Address - Country:US
Practice Address - Phone:303-379-9371
Practice Address - Fax:303-284-4082
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO121230207R00000X
CO10053363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15450589Medicaid
COP01103947OtherRAILROAD MEDICARE PTAN
CO15450589Medicaid