Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0995346-NP | CO |
NPI | 1083239941 |
---|---|
Provider Name | Marguerite Rice Shifrin |
First Address | Longmont, CO 80504-1236 |
Second Address | Boulder, CO 80303-1131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2020 |
Last Update Date | 16/06/2020 |