Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APN.0990995-NP | CO |
NPI | 1063753481 |
---|---|
Provider Name | Laura Rachel Greenbaum |
First Address | Westminster, CO 80021-4271 |
Second Address | Denver, CO 80207-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 26/01/2015 |