Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 54941 | TN |
Y | 207SG0201X | Clinical Genetics (M.D.) | DR.0063251 | CO |
N | 208000000X | Pediatrician | DR.0063251 | CO |
NPI | 1235428426 |
---|---|
Provider Name | Jessica Bulbin Duis |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2011 |
Last Update Date | 13/02/2020 |