Jonathan Avila

Individual provider Active NPI Nurse's Aide · Fort Collins, CO

NPI 1750147328 · NPPES record last updated Mar 13, 2025

Key facts

NPI
1750147328
Entity type
Individual (NPI type 1)
Primary specialty
Nurse's Aide 376K00000X
License
NA.00804905 (CO)
Practice address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone
(970) 494-4200
Fax
(844) 270-1824
NPI assigned
Feb 22, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NA.00804905COMDNurse's Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NA.00804905 CO Yes

Addresses

Primary practice location

4856 Innovation Dr
Fort Collins, CO 80525-5539

Mailing address

4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200

Other providers in Fort Collins, CO

All providers in Fort Collins, CO · Nurse's Aide in Colorado

Sources for this page

Verify at the official NPI Registry.