Provider Demographics
NPI:1659378644
Name:JARVIS, NEVA JEAN (RN, MS, CPNP)
Entity Type:Individual
Prefix:
First Name:NEVA
Middle Name:JEAN
Last Name:JARVIS
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 S FEDERAL BLVD
Mailing Address - Street 2:B
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4316
Mailing Address - Country:US
Mailing Address - Phone:303-797-4260
Mailing Address - Fax:303-783-9978
Practice Address - Street 1:4107B S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-4316
Practice Address - Country:US
Practice Address - Phone:303-781-1636
Practice Address - Fax:303-783-9978
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO88626363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38787083Medicaid