Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5873 | CO |
NPI | 1295971422 |
---|---|
Provider Name | Rebecca Prosen |
First Address | Erie, CO 80516-6522 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2008 |
Last Update Date | 12/06/2018 |