Provider Demographics
NPI:1891028288
Name:ERLENBUSCH, JILL K (NP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:K
Last Name:ERLENBUSCH
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 1:5920 MCINTYRE ST
Mailing Address - Street 2:ROCKY MOUNTAIN SENIOR CARE
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7445
Mailing Address - Country:US
Mailing Address - Phone:303-525-7250
Mailing Address - Fax:303-531-5088
Practice Address - Street 1:5920 MCINTYRE ST
Practice Address - Street 2:ROCKY MOUNTAIN SENIOR CARE
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-7445
Practice Address - Country:US
Practice Address - Phone:303-525-7250
Practice Address - Fax:303-531-5088
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP4008363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner