Provider Demographics
NPI:1598803579
Name:MCDERMITT, JANET M (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:MCDERMITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:720-754-4800
Mailing Address - Fax:720-754-4801
Practice Address - Street 1:1721 E 19TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1258
Practice Address - Country:US
Practice Address - Phone:720-754-4800
Practice Address - Fax:720-754-4801
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2132363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96772051Medicaid
COCOA103279Medicare PIN