Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0990771 | CO |
NPI | 1003215344 |
---|---|
Provider Name | Paula Jiron-Finn |
First Address | Pueblo, CO 81003-1330 |
Second Address | Canon City, CO 81212-4911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2014 |
Last Update Date | 21/08/2014 |