Healthcare Provider Details

I. General information

NPI: 1821410366
Provider Name (Legal Business Name): AMANDA JAIKEL R.N., N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10065 E HARVARD AVE STE 400
DENVER CO
80231-5943
US

IV. Provider business mailing address

600 W COUNTY LINE RD APT 12-001
HIGHLANDS RANCH CO
80129-6521
US

V. Phone/Fax

Practice location:
  • Phone: 303-614-1400
  • Fax:
Mailing address:
  • Phone: 228-355-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1623577
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0990960
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: