Provider Demographics
NPI:1508415258
Name:PANKRATZ, ANNE OLIVER (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:OLIVER
Last Name:PANKRATZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2736
Mailing Address - Country:US
Mailing Address - Phone:913-205-2724
Mailing Address - Fax:
Practice Address - Street 1:10900 SMITH RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-3262
Practice Address - Country:US
Practice Address - Phone:303-371-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily