=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952228025
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSELINE BANNELY TORRES FERNANDEZ AGNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2026
-----------------------------------------------------
Last Update Date | 06/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12605 E 16TH AVE
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80045-2520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-848-0000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7459 LA QUINTA PL
-----------------------------------------------------
City | LONE TREE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80124-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-688-0044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WX0200X
-----------------------------------------------------
Taxonomy Name | Oncology Registered Nurse
-----------------------------------------------------
License Number | 1656043
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------