Provider Demographics
NPI:1811968845
Name:FOLLMER, JANICE (CRNA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:FOLLMER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1276
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-1276
Mailing Address - Country:US
Mailing Address - Phone:970-389-7545
Mailing Address - Fax:
Practice Address - Street 1:905 COLUMBINE RD # E
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-1276
Practice Address - Country:US
Practice Address - Phone:970-389-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ05843100367500000X
TXAP119575367500000X
CO95498367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered