Provider Demographics
NPI:1306962220
Name:GAGLIANO, NICOLETTE (CNS)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:
Last Name:GAGLIANO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:NICOLETTE
Other - Middle Name:
Other - Last Name:GAGLIANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNS
Mailing Address - Street 1:1231 S PARKER RD STE 102A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2157
Mailing Address - Country:US
Mailing Address - Phone:303-313-3528
Mailing Address - Fax:303-750-4366
Practice Address - Street 1:1231 S PARKER RD STE 102A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2157
Practice Address - Country:US
Practice Address - Phone:303-313-3528
Practice Address - Fax:303-750-4366
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61086364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult