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General NPI Number Information
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NPI Number | 1083137202
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Entity Type | Individual
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Provider Name | JORDAN DENEEN COSTLOW FNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 1445 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-2226
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Country | US
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Telephone | 303-600-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-2226
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Country | US
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Telephone | 303-600-3699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP134095
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0998687-NP
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License Number State | CO
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