Healthcare Provider Details

I. General information

NPI: 1568024180
Provider Name (Legal Business Name): JAMIE BEFORT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 84TH AVE STE W-202
THORNTON CO
80229-5326
US

IV. Provider business mailing address

9836 HOOKER CT
WESTMINSTER CO
80031-3278
US

V. Phone/Fax

Practice location:
  • Phone: 720-222-3315
  • Fax:
Mailing address:
  • Phone: 303-947-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0994744-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: