Individual
DR. JELENA A LICINA
Active
Individual
DR. JELENA A LICINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
50835
CO
207R00000X
Internal Medicine Physician
Primary
73953
MN
207R00000X
Internal Medicine Physician
ME 88772
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029545
KAISER COMMERCIAL NUMBER
CO
05
—
268901400
—
FL
05
—
59135727
—
CO
Enumeration date
12/01/2005
Last updated
05/15/2024
Update your record
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