1689623951 NPI number — DONNA JEAN CLARKIN I NP

Table of content: DONNA JEAN CLARKIN I NP (NPI 1689623951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689623951 NPI number — DONNA JEAN CLARKIN I NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLARKIN
Provider First Name:
DONNA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
I
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLARKIN
Provider Other First Name:
DONNA
Provider Other Middle Name:
I
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
I
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1689623951
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7200 S ALTON WAY
Provider Second Line Business Mailing Address:
STE A100
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-2207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-730-2229
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7780 S BROADWAY
Provider Second Line Business Practice Location Address:
320
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80122-2648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-730-2229
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  56867 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00001862 . This is a "RR MEDICARE PIN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".