Provider Demographics
NPI:1326452376
Name:NOWAKOWSKI, JOANNA (NP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:NOWAKOWSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 UCB WARDENBURG
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80309-0001
Mailing Address - Country:US
Mailing Address - Phone:303-492-5101
Mailing Address - Fax:
Practice Address - Street 1:1900 WARDENBURG DRIVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-3511
Practice Address - Country:US
Practice Address - Phone:303-492-5101
Practice Address - Fax:303-492-6861
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015095363LF0000X
CO0994136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily