Individual
MS. JACQUELINE ANN DUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
360 PEAK ONE DR STE 100, FRISCO, CO 80443-5948
(970) 668-4040
Mailing address
PO BOX 525, LEADVILLE, CO 80461-0525
(719) 838-0655
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0000930
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40820025
—
CO
Enumeration date
07/07/2005
Last updated
12/26/2024
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