Provider Demographics
NPI:1326586066
Name:WINTERHALDER, JADE MEADOW (RN)
Entity Type:Individual
Prefix:MRS
First Name:JADE
Middle Name:MEADOW
Last Name:WINTERHALDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5691 S YOUNGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4518
Mailing Address - Country:US
Mailing Address - Phone:720-229-2507
Mailing Address - Fax:
Practice Address - Street 1:5691 S YOUNGFIELD ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4518
Practice Address - Country:US
Practice Address - Phone:720-229-2507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1636319163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse