Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0000151 | CO |
NPI | 1104257039 |
---|---|
Provider Name | Jillian Freeland |
First Address | Colorado Springs, CO 80910-1510 |
Second Address | Colorado Springs, CO 80910-1510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2013 |
Last Update Date | 03/12/2013 |