Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP02090 | LA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 180648 | CO |
NPI | 1225251259 |
---|---|
Provider Name | Dallas Arnold Estey |
First Address | Firestone, CO 80504-6740 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 31/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1409430 | (05) | LA |