Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2016-00590 | NC |
Y | 207Q00000X | Family Doctor | DR.0054166 | CO |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2016-00590 | NC |
NPI | 1225392210 |
---|---|
Provider Name | Sara Allison Warzecka |
First Address | Grand Junction, CO 81506-8723 |
Second Address | Grand Junction, CO 81506-8723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 18/02/2020 |