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NPI Code Detail

MEDICARE: JAE AN RN

MEDICARE: JAE AN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1657796CO

General Provider Information

NPI Number : 1063229409
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAE AN RN
Provider Business Mailing Address
First Line : 6917 S EATON PARK CT # USA
Second Line :
City : AURORA
State : CO
Zip : 80016-4328
Country : US
Telephone Number : 573-639-0836
Fax Number :
Provider Business Practice Location Address
First Line : 3425 S CLARKSON ST
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-2899
Country : US
Telephone Number : 303-789-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2024
Last Update Date : 12/17/2024

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Directions to “ JAE AN RN” Practice Location

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