MEDICARE: CARRIE JANELLE EVERETT FNP

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	APN.1001508-NP	CO

General Provider Information

NPI Number	:	1609713973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE JANELLE EVERETT FNP

Provider Business Mailing Address
First Line	:	11652 FAIRPLAY ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80603-7224
Country	:	US
Telephone Number	:	303-808-0511
Fax Number	:

Provider Business Practice Location Address
First Line	:	11652 FAIRPLAY ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80603-7224
Country	:	US
Telephone Number	:	303-808-0511
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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