Healthcare Provider Details
I. General information
NPI: 1164419800
Provider Name (Legal Business Name): JILL HULBERT N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2005
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1421 S POTOMAC ST SUITE 40
AURORA CO
80012-4535
US
IV. Provider business mailing address
PO BOX 441186
AURORA CO
80044-1186
US
V. Phone/Fax
- Phone: 303-750-0822
- Fax: 303-750-1298
- Phone: 303-295-8737
- Fax: 303-298-1862
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 108361 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: