Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 092404 | IA |
N | 222Z00000X | Podiatrist | 092404 | IA |
Y | 213E00000X | Podiatrist | 879 | CO |
Y | 222Z00000X | Podiatrist | 879 | CO |
N | 213EP0504X | Public Medicine | 092404 | IA |
N | 213EP1101X | Primary Podiatric Medicine | 092404 | IA |
N | 213ES0103X | Foot & Ankle Surgery | 092404 | IA |
NPI | 1306322201 |
---|---|
Provider Name | Erica Seybold |
First Address | Aurora, CO 80016-1786 |
Second Address | Aurora, CO 80016-1786 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2018 |
Last Update Date | 23/07/2021 |