Provider Demographics
NPI:1831157189
Name:PRAGER, JANET ELLEN (FNP)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:ELLEN
Last Name:PRAGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 TROYER AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-9749
Mailing Address - Country:US
Mailing Address - Phone:970-464-4924
Mailing Address - Fax:
Practice Address - Street 1:DEPT #0861
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80256-0001
Practice Address - Country:US
Practice Address - Phone:866-898-7136
Practice Address - Fax:616-975-9824
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64381587Medicaid
UTT0166Medicaid
COC222228Medicare PIN
UTT0166Medicaid