Healthcare Provider Details

I. General information

NPI: 1083002372
Provider Name (Legal Business Name): JACOB WEINSTEIN APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 E TENNESSEE AVE STE 325
DENVER CO
80224-1645
US

IV. Provider business mailing address

700 COLORADO BLVD # 735
DENVER CO
80206-4084
US

V. Phone/Fax

Practice location:
  • Phone: 720-541-9570
  • Fax: 907-449-0575
Mailing address:
  • Phone: 773-223-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberAPN.0991533-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN-0991533-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: