Individual
MRS. JAN GILLESPIE-WAGNER
Active
Individual
MRS. JAN GILLESPIE-WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26768
CO
208VP0014X
Interventional Pain Medicine Physician
Primary
26768
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01267681
—
CO
05
—
102189300
—
WY
01
—
187075800
DEPARTMENT OF LABOR
—
01
—
GI160818
ANTHEM BCBS
CO
Enumeration date
11/23/2005
Last updated
11/30/2020
Update your record
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