MEDICARE: JANET DERAS 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
1	163WE0003X	Emergency Registered Nurse	RN-1630049	CO

General Provider Information

NPI Number	:	1497565402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET DERAS RN

Provider Business Mailing Address
First Line	:	9758 LAREDO ST UNIT 19D
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-9812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9758 LAREDO ST UNIT 19D
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-9812
Country	:	US
Telephone Number	:	720-496-5593
Fax Number	:

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

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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