Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A9705 | CA |
Y | 207QA0505X | Family Doctor - Adult Medicine | 0050719 | CO |
NPI | 1275657504 |
---|---|
Provider Name | Valerie A Gibson |
First Address | Denver, CO 80211-3121 |
Second Address | Denver, CO 80211-3121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 17/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CE942S | (02) | CA |
CE942T | (02) | CA |
CE942U | (02) | CA |
CE942W | (02) | CA |
CE942X | (02) | CA |
CE942Y | (02) | CA |
CE972V | (02) | CA |