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NPI Code Detail

MEDICARE: ALEXIS IVANS JANECKA FNP, WHNP

MEDICARE:   ALEXIS IVANS JANECKA  FNP, WHNP
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
1363L00000XNurse Practitioner5008435NC
2363LW0102XWomen's Health Nurse Practitioner0993233CO

General Provider Information

NPI Number : 1295197234
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS IVANS JANECKA FNP, WHNP
Provider Business Mailing Address
First Line : 4430 S ADAMS COUNTY PKWY
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-8222
Country : US
Telephone Number : 720-369-5166
Fax Number :
Provider Business Practice Location Address
First Line : 4430 S ADAMS COUNTY PKWY
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-8222
Country : US
Telephone Number : 720-369-5166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2016
Last Update Date : 01/11/2023

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