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:
Health care specialties
| Specialty | Code | License # | 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 11 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 | 1043202385 | NPPES |
| Colorado | MEDICAID | 01336981 |
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