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NPI 1649200981

NPI 1649200981 : JILL M PARKER PA : COLORADO SPRINGS, CO

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General NPI Number Information
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    NPI Number           |    1649200981
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    Entity Type          |    Individual 
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    Provider Name        |    JILL M PARKER PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/03/2006
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    Last Update Date     |    09/23/2008
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Provider Practice Location Address
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    Address Line         |    8890 N UNION BLVD SUITE 200
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80920-7799
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    Country              |    US
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    Telephone            |    719-548-0700
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    Fax                  |    719-593-0949
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Provider Business Mailing Address
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    Address Line         |    8890 N UNION BLVD SUITE 200
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80920-7799
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    Country              |    US
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    Telephone            |    719-548-0700
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    Fax                  |    719-593-0949
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    399
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    License Number State |    CO
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