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General NPI Number Information
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NPI Number | 1447560065
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Entity Type | Individual
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Provider Name | JETTE ROSHOLM HOGENMILLER PHD, MN, ARNP, CDE
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Gender | Female
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Dates
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Enumeration Date | 10/16/2010
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 12230 LIONESS WAY
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City | PARKER
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State | CO
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Zip | 80134-5603
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Country | US
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Telephone | 720-644-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 9250 E COSTILLA AVE STE 540
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80112-3648
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Country | US
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Telephone | 720-644-9355
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Fax | 303-661-1861
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110088
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 025803 A099882
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP 3000 3517
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2010009933
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30003517
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0100085-C-NP
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License Number State | CO
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