Individual
JEANINE LABAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, PSYD
Contact information
Practice address
1250 N WILSON AVE, LOVELAND, CO 80537-4461
(970) 494-4200
Mailing address
4856 INNOVATION DR STE B, FORT COLLINS, CO 80525-5540
(970) 494-4200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY.0000790
CO
163W00000X
Registered Nurse
RN.0045886
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0990892-NP
CO
364S00000X
Clinical Nurse Specialist
APN.0000326-CNS
CO
Other
Enumeration date
07/31/2006
Last updated
05/30/2019
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