Individual
JACKI SUE DEGOLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
999 18TH ST STE 3000, DENVER, CO 80202-2449
(888) 731-8994
Mailing address
999 18TH ST STE 3000, DENVER, CO 80202-2449
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0996679-NP
CO
363LP2300X
Primary Care Nurse Practitioner
Primary
5019545
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0175594
COLORADO REGISTERED NURSE LICENSE
CO
01
—
0996679-NP
ADVANCED PRACTICE NURSE
CO
01
—
227042
CDE SPECIAL SERVICE PROVIDER
CO
01
—
364412
REGISTERED NURSE
NC
01
—
5019545
ADVANCED PRACTICE NURSE
NC
Enumeration date
07/09/2021
Last updated
12/15/2025
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