Healthcare Provider Details

I. General information

NPI: 1225261696
Provider Name (Legal Business Name): GILLIAN L CREMONA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9094 E MINERAL CIR STE 100
CENTENNIAL CO
80112-7201
US

IV. Provider business mailing address

32 WEDGE WAY
LITTLETON CO
80123-6630
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3200
  • Fax: 303-694-2680
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0990002
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: