Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 89265 | CO |
NPI | 1013005719 |
---|---|
Provider Name | Michele Hinneberg |
First Address | Aurora, CO 80010-3914 |
Second Address | Commerce City, CO 80022-2343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 06/04/2021 |