Bearden, Jacqueline S
Bearden, Jacqueline S is an individual health care provider with primary practice located at 5623 W 19Th St , Greeley CO 80634-2901. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bearden, Jacqueline S can be contacted via phone (970) 353-9011.Contact Information
Primary practice address
5623 W 19Th St
Greeley CO 80634-2901
Phone: (970) 353-9011
Fax: (970) 353-9135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 27516 | Colorado |
Profile Details
| NPI number | 1013912930 |
|---|---|
| LBN Legal business name | Bearden, Jacqueline S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Jan 5th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013912930 | NPPES |
| Colorado | MEDICAID | 72506717 |
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