Provider Demographics
NPI:1528883360
Name:NAZARENKO, ELENA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:NAZARENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-0102
Mailing Address - Country:US
Mailing Address - Phone:720-937-5048
Mailing Address - Fax:
Practice Address - Street 1:5322 ADAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2333
Practice Address - Country:US
Practice Address - Phone:720-937-5048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver