Provider Demographics
NPI:1952302366
Name:OMMEN, JANET D (MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:D
Last Name:OMMEN
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W HWY 50
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2238
Mailing Address - Country:US
Mailing Address - Phone:719-530-2048
Mailing Address - Fax:719-530-2055
Practice Address - Street 1:28374 COUNTY ROAD 317
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211-9158
Practice Address - Country:US
Practice Address - Phone:719-530-2048
Practice Address - Fax:719-530-2055
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO59858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COS28648Medicare UPIN
CO802131Medicare PIN