Healthcare Provider Details

I. General information

NPI: 1053448001
Provider Name (Legal Business Name): JANICE C VANDERWERF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 20TH AVE DEPT 2096, NEUROLOGY
DENVER CO
80205-5423
US

IV. Provider business mailing address

1375 E 20TH AVE DEPT 2096, NEUROLOGY
DENVER CO
80205-5423
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3380
  • Fax: 303-861-3385
Mailing address:
  • Phone: 303-861-3380
  • Fax: 303-861-3385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number111886
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: