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NPI Code Detail

MEDICARE: JESSICA M NANCE RN

MEDICARE:   JESSICA M NANCE  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.1620316CO

General Provider Information

NPI Number : 1174984587
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA M NANCE RN
Provider Business Mailing Address
First Line : 7155 E 38TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80207-1630
Country : US
Telephone Number : 303-321-2458
Fax Number : 303-321-0498
Provider Business Practice Location Address
First Line : 3480 CENTENNIAL BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-4087
Country : US
Telephone Number : 719-475-7162
Fax Number : 719-475-2201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2016
Last Update Date : 03/11/2016

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