Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | DR.0062005 | CO |
NPI | 1578976627 |
---|---|
Provider Name | Dr. Jessica Lynn Specht |
First Address | Lone Tree, CO 80124-5644 |
Second Address | Lone Tree, CO 80124-5644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2014 |
Last Update Date | 19/07/2019 |