Provider Demographics
NPI:1871295105
Name:PIPER, JACIA DAWN (FNP)
Entity type:Individual
Prefix:
First Name:JACIA
Middle Name:DAWN
Last Name:PIPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81073-1636
Mailing Address - Country:US
Mailing Address - Phone:719-523-6628
Mailing Address - Fax:719-523-4290
Practice Address - Street 1:900 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:CO
Practice Address - Zip Code:81073-1636
Practice Address - Country:US
Practice Address - Phone:719-523-6628
Practice Address - Fax:719-523-4290
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998392-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner