MEDICARE: CAREN D MISKY NP

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
1	363L00000X	Nurse Practitioner	118585	CO
2	363L00000X	Nurse Practitioner	APN.0004365-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	APRN002731	OTHER	NV	NV LICENSE

General Provider Information

NPI Number	:	1215903828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAREN D MISKY NP

Provider Business Mailing Address
First Line	:	3455 RINGSBY CT STE 102
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80216-4923
Country	:	US
Telephone Number	:	303-904-7240
Fax Number	:	720-598-0440

Provider Business Practice Location Address
First Line	:	3455 RINGSBY CT STE 102
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80216-4923
Country	:	US
Telephone Number	:	303-904-7240
Fax Number	:	720-598-0440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	01/08/2020

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