Healthcare Provider Details

I. General information

NPI: 1982232443
Provider Name (Legal Business Name): JASMINE PIXLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 E ILIFF PL
AURORA CO
80014-6512
US

IV. Provider business mailing address

13620 E ILIFF PL
AURORA CO
80014-6512
US

V. Phone/Fax

Practice location:
  • Phone: 803-761-8141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: