Healthcare Provider Details

I. General information

NPI: 1841420098
Provider Name (Legal Business Name): WENDY PABILONIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 E BELLEVIEW AVE 301
GREENWOOD VILLAGE CO
80111-1617
US

IV. Provider business mailing address

6162 S. WILLOW DRIVE SUITE 100
GREENWOOD VILLAGE CO
80111-5114
US

V. Phone/Fax

Practice location:
  • Phone: 303-220-9200
  • Fax: 303-220-9208
Mailing address:
  • Phone: 303-220-9200
  • Fax: 303-220-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP-5970
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: