Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 178286 | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 990333 | CO |
NPI | 1023308343 |
---|---|
Provider Name | Serena M.e. Snow |
First Address | Denver, CO 80206-2761 |
Second Address | Denver, CO 80206-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
57075760 | (05) | CO |