Provider Demographics
NPI:1528541901
Name:STARFISH WELLNESS LLC
Entity Type:Organization
Organization Name:STARFISH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:NAWROCKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:303-945-6819
Mailing Address - Street 1:677 S COLORADO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8019
Mailing Address - Country:US
Mailing Address - Phone:720-744-0666
Mailing Address - Fax:
Practice Address - Street 1:677 S COLORADO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8019
Practice Address - Country:US
Practice Address - Phone:720-744-0666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center