Provider Demographics
NPI:1487780656
Name:GANO, JOYCE (NP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:GANO
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 1:3037 S GRAPE WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6809
Mailing Address - Country:US
Mailing Address - Phone:303-692-0439
Mailing Address - Fax:303-758-6095
Practice Address - Street 1:4745 S HELENA WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1709
Practice Address - Country:US
Practice Address - Phone:720-260-0188
Practice Address - Fax:303-758-6095
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO58478363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08209324Medicaid
CO08209324Medicaid
CO343838Medicare ID - Type Unspecified