Basic Information
Provider Information
NPI: 1316589732
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: JILL
MiddleName: CHRISTINE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8698 E 25TH DR
Address2:  
City: DENVER
State: CO
PostalCode: 802382750
CountryCode: US
TelephoneNumber: 3038071968
FaxNumber:  
Practice Location
Address1: 1700 WHEELING ST
Address2:  
City: AURORA
State: CO
PostalCode: 800457211
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2019
LastUpdateDate: 10/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPN.0995062-NPCOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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