Individual
JACQUELINE C. FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
315 CANYON AVE, SUITE 1, FORT COLLINS, CO 80521-2677
(970) 472-6789
(970) 472-6799
Mailing address
315 CANYON AVE, SUITE 1, FORT COLLINS, CO 80521-2677
(970) 472-6789
(970) 472-6799
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33698
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01336981
—
CO
Enumeration date
08/22/2005
Last updated
10/02/2013
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