Provider Demographics
NPI:1467555409
Name:WOLVIN, JANET LEIGH (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEIGH
Last Name:WOLVIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7306
Mailing Address - Country:US
Mailing Address - Phone:970-382-2000
Mailing Address - Fax:970-382-2069
Practice Address - Street 1:1800 E 3RD AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5016
Practice Address - Country:US
Practice Address - Phone:970-764-1790
Practice Address - Fax:970-375-7927
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2013-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO112132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
C463538Medicare ID - Type Unspecified
P58109Medicare UPIN