Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125069919 | IL |
Y | 207VX0201X | Gynecologic Oncologist | DR.0065822 | CO |
NPI | 1003357245 |
---|---|
Provider Name | Christianne Persenaire |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 22/09/2021 |