Healthcare Provider Details

I. General information

NPI: 1174827984
Provider Name (Legal Business Name): JEANNE JIYOUNG MIN MSN, RNC, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax: 303-436-6328
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-436-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN.0002375-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: