Basic Information
| Provider Information | |||||||||
| NPI: | 1164448221 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IVERSON | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | FNP-C, CNS | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CURREN | ||||||||
| OtherFirstName: | DEBRA | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNS | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10485 N. SHERIDAN BLVD | ||||||||
| Address2: | UNIT #200 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034668344 | ||||||||
| FaxNumber: | 3035862250 | ||||||||
| Practice Location | |||||||||
| Address1: | 10485 N. SHERIDAN BLVD | ||||||||
| Address2: | UNIT #200 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034668344 | ||||||||
| FaxNumber: | 3035862250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 07/19/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN.0991009-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 364S00000X | 79473 | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 363LF0000X | 0991009 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 20130117352 | 01 | FNP CERTIFICATION (ANCC) | OTHER | APN.0991009-NP | 01 | CO | COLORADO BOARD OF NURSING | OTHER | 20620106 | 01 | NCBDE-CERTIFIED DIABETES EDUCATOR | OTHER | 79473 | 01 | CO | COLORADO BOARD OF NURSING | OTHER | 200600694 | 01 | BC-ADM ADVANCED DIABETES MANAGEMENT | OTHER |