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General NPI Number Information
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NPI Number | 1588648166
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Entity Type | Individual
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Provider Name | JEAN MAY LU MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 5995 IRIS PKWY
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City | FREDERICK
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State | CO
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Zip | 80504-6412
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Country | US
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Telephone | 303-697-2583
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Fax | 303-833-6515
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Provider Business Mailing Address
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Address Line | 203 S ROLLIE AVE
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City | FORT LUPTON
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State | CO
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Zip | 80621-1508
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Country | US
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Telephone | 303-892-6401
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Fax | 303-286-4589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0045895
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License Number State | CO
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