Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MWR.0000166 | CO |
NPI | 1023452349 |
---|---|
Provider Name | Kattie Jane Jones |
First Address | Thornton, CO 80233-3848 |
Second Address | Thornton, CO 80233-3848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 16/11/2015 |