Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | C-APN.0000314-C-NP | CO |
NPI | 1043686785 |
---|---|
Provider Name | Catherine Fairbanks Stevens |
First Address | Denver, CO 80204 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2015 |
Last Update Date | 08/01/2021 |