Provider Demographics
NPI:1598853293
Name:GIUSTINA, GENNIFER (RN CPNP)
Entity Type:Individual
Prefix:MS
First Name:GENNIFER
Middle Name:
Last Name:GIUSTINA
Suffix:
Gender:F
Credentials:RN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13624 N TRAVOIS TRL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8617
Mailing Address - Country:US
Mailing Address - Phone:303-841-0158
Mailing Address - Fax:
Practice Address - Street 1:4200 E 9TH AVE
Practice Address - Street 2:BOX C 2885 ROOM 1503
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80262-0001
Practice Address - Country:US
Practice Address - Phone:303-315-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO57477363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07574775Medicaid
1495OtherNCBPNP/N
CO57477OtherRN LICENSE NO.