Provider Demographics
NPI:1760409551
Name:GILDEN, JANE C (NP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:C
Last Name:GILDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1047
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-1047
Mailing Address - Country:US
Mailing Address - Phone:719-539-4144
Mailing Address - Fax:719-539-4881
Practice Address - Street 1:448 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2804
Practice Address - Country:US
Practice Address - Phone:719-539-4144
Practice Address - Fax:719-593-4881
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83778363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96607572Medicaid
CO96607572Medicaid
COP24997Medicare UPIN