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Individual

JACQUELINE A. FITCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10101 RIDGEGATE PARKWAY, LONE TREE, CO 80124-9810
(720) 225-1900
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0000888
CO
363AM0700X
Medical Physician Assistant
888
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37729578
CO
01
P00302399
RAILROAD MEDICARE
CO
Enumeration date
08/18/2005
Last updated
07/31/2015
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