Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN0993257-NP | CO |
NPI | 1215476320 |
---|---|
Provider Name | Summer De La Garza |
First Address | Commerce City, CO 80022-3310 |
Second Address | Commerce City, CO 80022-3310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2017 |
Last Update Date | 26/08/2017 |