Healthcare Provider Details

I. General information

NPI: 1033169172
Provider Name (Legal Business Name): JILL N SERRAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 E 9TH AVE STE 350
DENVER CO
80220-4069
US

IV. Provider business mailing address

4600 E 9TH AVE STE 350
DENVER CO
80220-4069
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-2166
  • Fax: 303-861-7211
Mailing address:
  • Phone: 303-321-2166
  • Fax: 303-861-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44029
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: