Provider Demographics
NPI:1043354087
Name:PRIZZNICK, CAROL DENISE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:DENISE
Last Name:PRIZZNICK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:DENISE
Other - Last Name:PRIZZNICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:400 BORADACRES DRIVE
Mailing Address - Street 2:STE 445
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3156
Mailing Address - Country:US
Mailing Address - Phone:739-661-8300
Mailing Address - Fax:973-661-8333
Practice Address - Street 1:2479 S CLERMONT STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6588
Practice Address - Country:US
Practice Address - Phone:720-974-7275
Practice Address - Fax:973-661-8333
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA351252363LF0000X
COAPN.0995919-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily