Healthcare Provider Details

I. General information

NPI: 1629785704
Provider Name (Legal Business Name): CAROLINE WOZNIAKOWSKI APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 10/28/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4795 LARIMER PKWY
JOHNSTOWN CO
80534-9021
US

IV. Provider business mailing address

1451 EDORA RD
FORT COLLINS CO
80525-1247
US

V. Phone/Fax

Practice location:
  • Phone: 970-682-3203
  • Fax:
Mailing address:
  • Phone: 214-620-1626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0997957
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: