MEDICARE: JILLIAN RAMAGE FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	0995176	CO

General Provider Information

NPI Number	:	1275068496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN RAMAGE FNP-BC

Provider Business Mailing Address
First Line	:	2042 LOWELL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5054
Country	:	US
Telephone Number	:	631-384-1086
Fax Number	:

Provider Business Practice Location Address
First Line	:	2042 LOWELL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5054
Country	:	US
Telephone Number	:	631-384-1086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	04/09/2020

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