Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 45855 | CO |
N | 208000000X | Pediatrician | A89080 | CA |
NPI | 1013065036 |
---|---|
Provider Name | Natalia Michelle Prada |
First Address | Centennial, CO 80015-5307 |
Second Address | Centennial, CO 80015-5307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 18/01/2008 |