Healthcare Provider Details

I. General information

NPI: 1831157189
Provider Name (Legal Business Name): JANET ELLEN PRAGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPT #0861
DENVER CO
80256-0001
US

IV. Provider business mailing address

349 TROYER AVE
PALISADE CO
81526-9749
US

V. Phone/Fax

Practice location:
  • Phone: 866-898-7136
  • Fax: 616-975-9824
Mailing address:
  • Phone: 970-464-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number89457
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: