Provider Demographics
NPI:1669560363
Name:NEFF, JOAN MARIE (CPNP)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:NEFF
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:MODEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:820 CASTLE VALLEY BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647-9453
Mailing Address - Country:US
Mailing Address - Phone:970-984-3333
Mailing Address - Fax:
Practice Address - Street 1:820 CASTLE VALLEY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:CO
Practice Address - Zip Code:81647-9453
Practice Address - Country:US
Practice Address - Phone:970-984-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82054363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06480373Medicaid