Provider Demographics
NPI:1174665467
Name:HILL-FELICETTI, JOANNE M (NP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:HILL-FELICETTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1394 SAGE DR
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:CO
Mailing Address - Zip Code:80615-8928
Mailing Address - Country:US
Mailing Address - Phone:970-481-7073
Mailing Address - Fax:
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:720-466-0822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY25444.0923363L00000X
COAPN.0001188-NP363LF0000X
CO104658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07046584Medicaid
COP00474553.OtherMEDICARE RAILROAD
CO461452YQXKMedicare PIN
CO07046584Medicaid
COCOA109803Medicare PIN