Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 24489 | CO |
NPI | 1053385492 |
---|---|
Provider Name | Dr. Beverly Elaine Donnelley |
First Address | Fort Collins, CO 80524-3957 |
Second Address | Fort Collins, CO 80524-3957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 05/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01244896 | (05) | CO |
84059624501 | PACIFICARE (01) | |
DO84038 | BCBS (01) | |
E46954 | (02) | CO |