Individual
JESSICA VANDERKWAAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206-2762
(303) 388-4461
(303) 398-1211
Mailing address
1040 HARRISON ST, DENVER, CO 80206-3517
(720) 883-8466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0185818
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
0992119
CO
390200000X
Student in an Organized Health Care Education/Training Program
0185818
CO
Other
Enumeration date
10/09/2015
Last updated
10/18/2022
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