Provider Demographics
NPI:1871515825
Name:GILGREN, JAMIE RENEE (AUD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:RENEE
Last Name:GILGREN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:2318 17TH AVE
Practice Address - Street 2:UNIT H
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-9747
Practice Address - Country:US
Practice Address - Phone:303-485-9720
Practice Address - Fax:303-485-9735
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD531231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO288715YR4SMedicare PIN
NYRA1887Medicare PIN
NY02565731Medicaid