Provider Demographics
NPI:1528022977
Name:PANKEY, JANEVA C (MD)
Entity Type:Individual
Prefix:DR
First Name:JANEVA
Middle Name:C
Last Name:PANKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANEVA
Other - Middle Name:P
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 16950
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85211-6950
Mailing Address - Country:US
Mailing Address - Phone:970-810-6087
Mailing Address - Fax:970-810-4531
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5154
Practice Address - Country:US
Practice Address - Phone:970-810-6087
Practice Address - Fax:970-810-4531
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0031501207LH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G870050Medicaid
A73145Medicare UPIN
CA00G870050Medicaid