Provider Demographics
NPI:1073032520
Name:PRATER, AMY HYDEN (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:HYDEN
Last Name:PRATER
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 S GAYLORD ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1829
Mailing Address - Country:US
Mailing Address - Phone:303-881-2570
Mailing Address - Fax:
Practice Address - Street 1:430 INDIANA ST STE 100
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5012
Practice Address - Country:US
Practice Address - Phone:303-736-9697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0177568163W00000X
COAPN.0997990-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse