Basic Information
| Provider Information | |||||||||
| NPI: | 1780289488 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILENDUKE | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | QUINN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 LARIMER STREET | ||||||||
| Address2: | NORTH CLASSROOM 5002, CAMPUS BOX 173 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80204 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1455 DIXON AVE | ||||||||
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| City: | LAFAYETTE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800268879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034438500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.