Healthcare Provider Details

I. General information

NPI: 1679710321
Provider Name (Legal Business Name): JAMIE K. PHELAN R.N.,M.S.N., N.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2009
Last Update Date: 02/17/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SKY RIDGE MEDICAL CENTER 10101 RIDGEGATE PARKWAY
LONE TREE CO
80124
US

IV. Provider business mailing address

5445 DTC PKWY STE 700
GREENWOOD VILLAGE CO
80111-3052
US

V. Phone/Fax

Practice location:
  • Phone: 720-225-2200
  • Fax: 720-225-2269
Mailing address:
  • Phone: 303-839-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number71062
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5375036111
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberRN0071062
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: