Provider Demographics
NPI:1922696921
Name:NAN, JIAN
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:
Last Name:NAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 E ARAPAHOE RD STE 275
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6109
Mailing Address - Country:US
Mailing Address - Phone:303-721-6123
Mailing Address - Fax:303-721-6630
Practice Address - Street 1:7700 E ARAPAHOE RD STE 275
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6109
Practice Address - Country:US
Practice Address - Phone:303-721-6123
Practice Address - Fax:303-721-6630
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002380171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty