Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0992217 | CO |
NPI | 1003360652 |
---|---|
Provider Name | Elizabeth Perkins-Pride |
First Address | Denver, CO 80209-2638 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2016 |
Last Update Date | 11/08/2016 |