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NPI Code Detail

MEDICARE: DEBORAH NOVAK RN

MEDICARE:   DEBORAH  NOVAK  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 0076509CO

General Provider Information

NPI Number : 1710396130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH NOVAK RN
Provider Business Mailing Address
First Line : 14069 E STANFORD CIR
Second Line : APT 206
City : AURORA
State : CO
Zip : 80015-5681
Country : US
Telephone Number : 360-485-3273
Fax Number :
Provider Business Practice Location Address
First Line : 10065 E HARVARD AVE
Second Line : SUITE 400
City : DENVER
State : CO
Zip : 80231-5968
Country : US
Telephone Number : 303-614-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2014
Last Update Date : 08/11/2014

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