MEDICARE: NEVA JEAN JARVIS RN, MS, CPNP

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	88626	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

General Provider Information

NPI Number	:	1659378644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEVA JEAN JARVIS RN, MS, CPNP

Provider Business Mailing Address
First Line	:	4107 S FEDERAL BLVD
Second Line	:	B
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-4316
Country	:	US
Telephone Number	:	303-797-4260
Fax Number	:	303-783-9978

Provider Business Practice Location Address
First Line	:	4107B S FEDERAL BLVD
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-4316
Country	:	US
Telephone Number	:	303-781-1636
Fax Number	:	303-783-9978

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/24/2014

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