Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | 93549 | CO |
NPI | 1669516290 |
---|---|
Provider Name | Sara A Dixon |
First Address | Westminster, CO 80031-6704 |
Second Address | Denver, CO 80205-5423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007568 | KAISER-COMMERCIAL NUMBER (01) |