Provider Demographics
NPI:1407304504
Name:MCNAUGHTON, JAMIE AIL (NP-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:AIL
Last Name:MCNAUGHTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1693
Mailing Address - Country:US
Mailing Address - Phone:314-541-6134
Mailing Address - Fax:
Practice Address - Street 1:2599 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5655
Practice Address - Country:US
Practice Address - Phone:720-536-8589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997844363LF0000X
COC-APN.0001102-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000167409Medicaid