Provider Demographics
NPI:1457573198
Name:WILSON-ARMSTRONG, JANET RAE (NNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:RAE
Last Name:WILSON-ARMSTRONG
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:RAE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NNP
Mailing Address - Street 1:2395 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4826
Mailing Address - Country:US
Mailing Address - Phone:719-268-9013
Mailing Address - Fax:
Practice Address - Street 1:3205 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5101
Practice Address - Country:US
Practice Address - Phone:719-776-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO130759363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO130759OtherEPIC