Healthcare Provider Details

I. General information

NPI: 1912237280
Provider Name (Legal Business Name): VALERIE NOVAK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

32499 WOODLAND DR
EVERGREEN CO
80439-9707
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-370-7551
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number123798
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number123798
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number123798
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number123798
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: