Jan W Alexander, CMT
Individual provider Active NPI Specialist · Fort Collins, CO
NPI 1053540484 · NPPES record last updated Jul 7, 2009
Key facts
- NPI
- 1053540484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 2767 (CO)
- Practice address
- 3938 JFK Pkwy Unit 11F
Fort Collins, CO 80525-3087 - Phone
- (970) 204-0516
- Fax
- (970) 204-6812
- NPI assigned
- Jul 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2767 | CO | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2767 | CO | Yes |
Addresses
Primary practice location
3938 JFK Pkwy Unit 11F
Fort Collins, CO 80525-3087
Mailing address
3938 JFK Pkwy Unit 11F
Fort Collins, CO 80525-3087
Phone (970) 204-0516
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35-2309556 | Other | CO | MASSAGE THERAPY |
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.