Provider Demographics
NPI:1023097896
Name:NELSON, AIMEE SUE (MD)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:SUE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8585 W 14TH AVE
Mailing Address - Street 2:SUITE B2
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-4857
Mailing Address - Country:US
Mailing Address - Phone:303-238-1201
Mailing Address - Fax:303-238-2981
Practice Address - Street 1:8585 W 14TH AVE
Practice Address - Street 2:SUITE B2
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4857
Practice Address - Country:US
Practice Address - Phone:303-238-1201
Practice Address - Fax:303-238-2981
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841365302016OtherRKY MTN HMO
CORO103008OtherGROUP ANTHEM BCBS
CO7101493OtherCIGNA
CO84136530201OtherPACIFICARE PPO
CONE103028OtherANTHEM BCBS
CO01318229Medicaid
CO080098558OtherRAILROAD MEDICARE
CO4507875OtherAETNA
CO04020541Medicaid
CO1023097896OtherNPI #
CO84136530205OtherPACIFICARE
1215981634OtherGROUP NPI
CO513142OtherMEDICARE GROUP NUMBER
CO84136530201OtherPACIFICARE PPO
CORO103008OtherGROUP ANTHEM BCBS
CO04020541Medicaid
CO513175ZVTAMedicare PIN