Provider Demographics
NPI:1124683602
Name:WELZ, MONA LILLY SHIRAZI (FNP-C)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:LILLY SHIRAZI
Last Name:WELZ
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 1:1667 COLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3300
Mailing Address - Country:US
Mailing Address - Phone:303-420-3131
Mailing Address - Fax:
Practice Address - Street 1:1667 COLE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3320
Practice Address - Country:US
Practice Address - Phone:303-653-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1618757163W00000X
COAPN.0994482-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse