Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 43358 | CO |
NPI | 1003889155 |
---|---|
Provider Name | Carrie A Noriega |
First Address | Grand Junction, CO 81501-8845 |
Second Address | Grand Junction, CO 81501-8845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38676737 | (05) | CO |
I42054 | (02) | CO |