Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 38440 | CO |
Y | 208600000X | Surgeon | 38440 | CO |
NPI | 1003932625 |
---|---|
Provider Name | Barbara D Mullen |
First Address | Arvada, CO 80004-4134 |
Second Address | Lafayette, CO 80026-3370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003919 | KAISER-COMMERCIAL NUMBER (01) |