Healthcare Provider Details

I. General information

NPI: 1760409551
Provider Name (Legal Business Name): JANE C GILDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 E 1ST ST
SALIDA CO
81201-2804
US

IV. Provider business mailing address

PO BOX 1047
SALIDA CO
81201-1047
US

V. Phone/Fax

Practice location:
  • Phone: 719-539-4144
  • Fax: 719-593-4881
Mailing address:
  • Phone: 719-539-4144
  • Fax: 719-539-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number83778
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: