Provider Demographics
NPI:1194852137
Name:REDFIELD, JUANITA R (MD)
Entity type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:R
Last Name:REDFIELD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14448 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-5702
Mailing Address - Country:US
Mailing Address - Phone:720-353-7898
Mailing Address - Fax:
Practice Address - Street 1:3000 LAWRENCE ST # 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3422
Practice Address - Country:US
Practice Address - Phone:800-449-4512
Practice Address - Fax:720-247-9950
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO24958573Medicaid
CO012722OtherKAISER COMMERCIAL
COCK11079Medicare PIN
COH29713Medicare UPIN