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NPI Code Detail

MEDICARE: MISS CAITLIN MARIE GILLESPIE B.A.

MEDICARE: MISS CAITLIN MARIE GILLESPIE B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1720328479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CAITLIN MARIE GILLESPIE B.A.
Provider Business Mailing Address
First Line : 2435 GAYLORD ST
Second Line :
City : DENVER
State : CO
Zip : 80205-5629
Country : US
Telephone Number : 303-915-7223
Fax Number :
Provider Business Practice Location Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2013
Last Update Date : 02/18/2013

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