Individual
MR. JONATHAN PAUL NIENHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
6685 GUNPARK DR, SUITE 102, BOULDER, CO 80301-3388
(303) 415-5199
(303) 415-5198
Mailing address
5450 WESTERN AVE, BOULDER, CO 80301-2709
(303) 415-5199
(303) 415-5198
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0003741-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24231860
—
CO
Enumeration date
10/10/2006
Last updated
11/09/2017
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