Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APN.0992588-NP | CO |
NPI | 1043661127 |
---|---|
Provider Name | Jessica Stoughton |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 27/09/2016 |