Individual
MS. JANET L CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4601 CORBETT DR., FORT COLLINS, CO 80528-4000
(970) 207-4800
(970) 207-4885
Mailing address
4601 CORBETT DR, FORT COLLINS, CO 80528-9579
(970) 207-4800
(970) 207-4885
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0990701-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN.0126662
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80155031
—
CO
01
—
P01244774
RR MEDICARE
CO
05
—
W25216
—
WY
Enumeration date
01/07/2013
Last updated
01/29/2021
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