Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APN.0994953-NP | CO |
NPI | 1003464934 |
---|---|
Provider Name | Jamie Stephen |
First Address | Grand Junction, CO 81505-6401 |
Second Address | Grand Junction, CO 81505-6401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2019 |
Last Update Date | 04/09/2019 |