Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 34648 | AZ |
Y | 207PE0004X | Emergency Medical Services | 38695 | CO |
NPI | 1154370336 |
---|---|
Provider Name | Annemarie Lynn Utz |
First Address | Boston, MA 02241-8283 |
Second Address | Denver, CO 80033-6005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 15/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41321324 | (05) | CO |
930103288 | RAILROAD MEDICARE (01) | |
H19369 | (02) |