Fields, Jacqueline C.

Fields, Jacqueline C. is an sole proprietor health care provider with primary practice located at 315 Canyon Ave Suite 1, Fort Collins CO 80521-2677. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Fields, Jacqueline C. can be contacted via phone (970) 472-6789.

Contact Information

Primary practice address
315 Canyon Ave Suite 1 Fort Collins CO 80521-2677
Phone: (970) 472-6789
Fax: (970) 472-6799
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 33698 Colorado

Profile Details

NPI number 1043202385
LBN Legal business name Fields, Jacqueline C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2005
Last updated Oct 2nd, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043202385 NPPES
Colorado MEDICAID 01336981

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