Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 56392 | CT |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 58739 | AZ |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | DR.0060398 | CO |
NPI | 1013274950 |
---|---|
Provider Name | Laura Vogel Abernathie |
First Address | Aurora, CO 80042-0429 |
Second Address | Phoenix, AZ 85016-4879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 05/05/2020 |