Healthcare Provider Details

I. General information

NPI: 1386187839
Provider Name (Legal Business Name): DENAE GALETTI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENAE ARCHER ATC

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CARSON AVE STE 201
LA JUNTA CO
81050-2748
US

IV. Provider business mailing address

1100 CARSON AVE STE 201
LA JUNTA CO
81050-2748
US

V. Phone/Fax

Practice location:
  • Phone: 719-383-5914
  • Fax:
Mailing address:
  • Phone: 719-383-5914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number200002288
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN-0999330-NP
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: