Provider Demographics
NPI:1487692000
Name:CAVEN, GEORGIA LEE (NP)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:LEE
Last Name:CAVEN
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 1:2005 FRANKLIN ST
Mailing Address - Street 2:MIDTOWN 2, SUITE 390
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5401
Mailing Address - Country:US
Mailing Address - Phone:303-318-2250
Mailing Address - Fax:303-318-2252
Practice Address - Street 1:2005 FRANKLIN ST
Practice Address - Street 2:MIDTOWN 2, SUITE 390
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-318-2250
Practice Address - Fax:303-318-2252
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORXP-99209363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48309311Medicaid
P30979Medicare UPIN
COC491788Medicare PIN