Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 45198 | CO |
N | 207RA0401X | Internist - Addiction Medicine | 45198 | CO |
N | 208D00000X | General Practice Physician | 45198 | CO |
N | 208D00000X | General Practice Physician | MD60648223 | WA |
NPI | 1588755458 |
---|---|
Provider Name | Jacqueline Denise Howard |
First Address | Aurora, CO 80015-5617 |
Second Address | Aurora, CO 80014-2802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 10/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1588755458 | NPI (01) | |
2072674 | (05) | WA |