Provider Demographics
NPI:1104043413
Name:BLANKE, JANE M (RN, CRNFA)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:BLANKE
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11351 W 75TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3526
Mailing Address - Country:US
Mailing Address - Phone:303-941-1759
Mailing Address - Fax:
Practice Address - Street 1:11351 W 75TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3526
Practice Address - Country:US
Practice Address - Phone:303-941-1759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO63753163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant