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General NPI Number Information
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NPI Number | 1891110292
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Entity Type | Individual
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Provider Name | GAIL LILY
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Gender | Female
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Dates
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Enumeration Date | 02/22/2014
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Last Update Date | 02/22/2014
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Provider Practice Location Address
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Address Line | 3636 S PEARL ST
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3806
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Country | US
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Telephone | 303-761-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 S BIRCH ST APT 307A
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City | GLENDALE
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State | CO
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Zip | 80246-2519
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Country | US
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Telephone | 303-525-0154
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Fax |
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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 | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | RN0168468
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License Number State | CO
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