Healthcare Provider Details

I. General information

NPI: 1003137936
Provider Name (Legal Business Name): JANINE L OLIVER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

12631 E 17TH AVE # MSC319
AURORA CO
80045-2527
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-1800
  • Fax:
Mailing address:
  • Phone: 303-724-2716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberA136113
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberDR.0057943
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: