Provider Demographics
NPI:1063883569
Name:NEZBETH, JOHN (FNP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:NEZBETH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 S MONACO PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1501
Mailing Address - Country:US
Mailing Address - Phone:303-913-5085
Mailing Address - Fax:
Practice Address - Street 1:895 S MONACO PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1501
Practice Address - Country:US
Practice Address - Phone:303-321-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-10
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991994-NP363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily