Healthcare Provider Details

I. General information

NPI: 1447140660
Provider Name (Legal Business Name): DAVID ACEVEDO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID WAYNE JETT RN

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3953 S ESPANA ST
AURORA CO
80013-4501
US

IV. Provider business mailing address

3953 S ESPANA ST
AURORA CO
80013-4501
US

V. Phone/Fax

Practice location:
  • Phone: 720-541-3564
  • Fax:
Mailing address:
  • Phone: 720-541-3564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number1685744
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: