Healthcare Provider Details

I. General information

NPI: 1164448221
Provider Name (Legal Business Name): DEBRA ANN IVERSON FNP-C, CNS, BC-ADM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10485 N. SHERIDAN BLVD UNIT #200
WESTMINSTER CO
80020
US

IV. Provider business mailing address

10485 N. SHERIDAN BLVD UNIT #200
WESTMINSTER CO
80020
US

V. Phone/Fax

Practice location:
  • Phone: 303-466-8344
  • Fax: 303-586-2250
Mailing address:
  • Phone: 303-466-8344
  • Fax: 303-586-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number79473
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0991009
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: