Provider Demographics
NPI:1720831688
Name:JOURNEYCAKE, CAROLINE ANNE (APN)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ANNE
Last Name:JOURNEYCAKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 E MISSISSIPPI AVE STE 1300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3057
Mailing Address - Country:US
Mailing Address - Phone:720-889-4254
Mailing Address - Fax:720-889-4258
Practice Address - Street 1:4100 E MISSISSIPPI AVE STE 1300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-3057
Practice Address - Country:US
Practice Address - Phone:720-889-4254
Practice Address - Fax:720-889-4258
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0999662363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health