Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 36002 | CO |
NPI | 1003943671 |
---|---|
Provider Name | Susan K Warner |
First Address | Denver, CO 80247-5104 |
Second Address | Denver, CO 80247-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008879 | KAISER-COMMERCIAL NUMBER (01) |