Provider Demographics
NPI:1124162425
Name:NYLEN, JESSICA (BA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:NYLEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 JOYCE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-1321
Mailing Address - Country:US
Mailing Address - Phone:720-238-2729
Mailing Address - Fax:
Practice Address - Street 1:1634 DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1529
Practice Address - Country:US
Practice Address - Phone:303-504-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator