Provider Demographics
NPI:1558907220
Name:REEVES, JOCELYN (AGNP)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 MCINTYRE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403
Mailing Address - Country:US
Mailing Address - Phone:720-434-4876
Mailing Address - Fax:303-225-4246
Practice Address - Street 1:5290 MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403
Practice Address - Country:US
Practice Address - Phone:720-434-4876
Practice Address - Fax:303-225-4246
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995294363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORN.0190527OtherRN
RXN.0104531-NPOtherCO RXN
COAPN.0995294-NPOtherAPN- NP