Provider Demographics
NPI:1821410366
Name:JAIKEL, AMANDA (RN, NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:JAIKEL
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W COUNTY LINE RD APT 12-001
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6521
Mailing Address - Country:US
Mailing Address - Phone:228-355-0187
Mailing Address - Fax:
Practice Address - Street 1:10065 E HARVARD AVE STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5943
Practice Address - Country:US
Practice Address - Phone:303-614-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1623577163W00000X
CO0990960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73879738Medicaid
CO024613OtherKAISER COMMERCIAL NUMBER
CO73879738Medicaid