Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 209-007558 | IL |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 991068 | CO |
NPI | 1063647436 |
---|---|
Provider Name | Jennifer K Dean |
First Address | Denver, CO 80247-1314 |
Second Address | Wheat Ridge, CO 80033-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2009 |
Last Update Date | 07/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024573 | (05) | CO |
024573 | KAISER COMMERCIAL NUMBER (01) | CO |