Individual
JAMIE NOELLE CANINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 BALSAM AVE, BOULDER, CO 80304-3404
(303) 440-2037
Mailing address
PO BOX 173894, DENVER, CO 80217-3894
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2295
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83121374
—
CO
01
—
P01086374
RAILROAD MEDICARE PIN
CO
Enumeration date
09/20/2007
Last updated
02/24/2014
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