Doctor Name: | JENEL R DEANE |
NPI Number: | 1740310580 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHARMD |
License Number: | 17217 |
Business Practice Address: | 11245 Huron St Denver, CO - 802342806 |
Business Phone Number: | 3034576051 |
Business Fax Number: | |
Mailing Address: | 11245 Huron St, DENVER |
State: | CO |
Postal Code: | 802342806 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 10/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |