Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 52618 | CO |
NPI | 1568600450 |
---|---|
Provider Name | Christianne Marie Mcgrath |
First Address | Colorado Springs, CO 80907-8731 |
Second Address | Colorado Springs, CO 80907-8731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 29/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12152323 | (05) | CO |
G86781 | (02) | CO |