Provider Demographics
NPI:1912861014
Name:SCHAFER, MALLORY ANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:ANNE
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 S POPPY ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-5942
Mailing Address - Country:US
Mailing Address - Phone:317-431-0820
Mailing Address - Fax:
Practice Address - Street 1:2373 CENTRAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2300
Practice Address - Country:US
Practice Address - Phone:720-524-8429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-12
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COF12250109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty