| Doctor Name: | MR. JOHN NEZBETH |
| NPI Number: | 1063883569 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 2009001163 |
| Business Practice Address: | 5920 Mcintyre St Golden, CO - 804037445 |
| Business Phone Number: | 3039491250 |
| Business Fax Number: | |
| Mailing Address: | 5920 Mcintyre St, GOLDEN |
| State: | CO |
| Postal Code: | 804037445 |
| Phone Number: | 3039491250 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2015 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 2009001163 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |