Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN.0991689-NP | CO |
NPI | 1235517590 |
---|---|
Provider Name | Taj Schimek |
First Address | Boulder, CO 80304 |
Second Address | Aurora, CO 80045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2015 |
Last Update Date | 07/05/2015 |