Gillespie-Wagner, Jan

Gillespie-Wagner, Jan is an individual health care provider with primary practice located at 1175 58Th Ave Ste 200, Greeley CO 80634-4807. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is her primary health care specialty. Gillespie-Wagner, Jan can be contacted via phone (970) 495-0444.

Contact Information

Primary practice address
1175 58Th Ave Ste 200 Greeley CO 80634-4807
Phone: (970) 495-0444
Fax: (970) 488-3106
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 26768 Colorado
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 26768 Colorado

Profile Details

NPI number 1043293921
LBN Legal business name Gillespie-Wagner, Jan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Nov 30th, 2020 - about 5 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 1043293921 NPPES
Other 187075800 DEPARTMENT OF LABOR
MEDICAID 01267681 DEPARTMENT OF LABOR
MEDICAID 102189300 DEPARTMENT OF LABOR
Other GI160818 DEPARTMENT OF LABOR

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