Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 83778 | CO |
NPI | 1760409551 |
---|---|
Provider Name | Jane C Gilden |
First Address | Salida, CO 81201-1047 |
Second Address | Salida, CO 81201-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 19/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
96607572 | (05) | CO |
P24997 | (02) | CO |