Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | DR.0057053 | CO |
N | 2080P0202X | Pediatric Cardiologist | DR.0057053 | CO |
NPI | 1588007082 |
---|---|
Provider Name | Jessica Stansauk |
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 | 15/04/2013 |
Last Update Date | 23/09/2021 |