Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 0045549 | CO |
N | 207N00000X | Dermatologist | A94628 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A94628 | CA |
NPI | 1205842051 |
---|---|
Provider Name | Dr. Nicole M. Annest |
First Address | Aurora, CO 80014-1618 |
Second Address | Lafayette, CO 80026-3370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 06/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018208 | KAISER COMMERCIAL NUMBER (01) | CO |
77534077 | (05) | CO |
I63722 | (02) |