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General NPI Number Information
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NPI Number | 1609019009
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Entity Type | Individual
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Provider Name | DOLLY GEORGE MABEN NP
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Gender | Female
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 7155 E 38TH AVE
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City | DENVER
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State | CO
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Zip | 80207-1630
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Country | US
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Telephone | 303-321-7526
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Fax | 303-861-0268
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Provider Business Mailing Address
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Address Line | 7155 E 38TH AVE
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City | DENVER
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State | CO
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Zip | 80207-1630
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Country | US
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Telephone | 303-321-7526
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Fax | 303-861-0268
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | UP004236G
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN.0991318-NP
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License Number State | CO
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