Provider Demographics
NPI:1033232541
Name:PRIMOZICH, JOAN IRENE (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:IRENE
Last Name:PRIMOZICH
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-226-6180
Mailing Address - Fax:720-870-1896
Practice Address - Street 1:1400 S POTOMAC ST STE 190
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4514
Practice Address - Country:US
Practice Address - Phone:209-790-8367
Practice Address - Fax:303-369-1919
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2010363L00000X
CO10073363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200750460AMedicaid
CO55832873Medicaid
COCOA106208Medicare PIN
KS200750460AMedicaid
COP01058176Medicare PIN