Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 209007065 | IL |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NP-990223 | CO |
NPI | 1003074105 |
---|---|
Provider Name | Mrs. Jill M Marks |
First Address | Aurora, CO 80040-0876 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 27/10/2011 |