Provider Demographics
NPI:1063604247
Name:KUWANA, MARY SHEFFIELD (DNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:SHEFFIELD
Last Name:KUWANA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4451
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:2450 S PEORIA ST STE 245
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5475
Practice Address - Country:US
Practice Address - Phone:303-752-7732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0180653163W00000X
COAPN.0005289-NP363LA2100X, 363LF0000X, 363L00000X
FLARNP9400046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03604811Medicaid
COCOA109709Medicare PIN
COAAA3729Medicare PIN
FLID236ZMedicare PIN