Provider Demographics
NPI:1215903828
Name:MISKY, CAREN D (NP)
Entity type:Individual
Prefix:
First Name:CAREN
Middle Name:D
Last Name:MISKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 RINGSBY CT STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-4923
Mailing Address - Country:US
Mailing Address - Phone:303-904-7240
Mailing Address - Fax:720-598-0440
Practice Address - Street 1:3455 RINGSBY CT STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-4923
Practice Address - Country:US
Practice Address - Phone:303-904-7240
Practice Address - Fax:720-598-0440
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO118585363L00000X
COAPN.0004365-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82073317Medicaid
NVAPRN002731OtherNV LICENSE
COC538078Medicare PIN
COQ18248Medicare UPIN