Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | C-APN.0002887-C-NP | CO |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP125132 | TX |
NPI | 1609291624 |
---|---|
Provider Name | Brandi Mccall |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2014 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
359774201 | (05) | TX |
800973 | STATE LICENSE (01) | TX |