Provider Demographics
NPI:1962437574
Name:PITCHER, JILLANE K (DO)
Entity type:Individual
Prefix:
First Name:JILLANE
Middle Name:K
Last Name:PITCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45795 COAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-4354
Mailing Address - Country:US
Mailing Address - Phone:720-874-3579
Mailing Address - Fax:303-341-1283
Practice Address - Street 1:45795 COAL CREEK DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-4354
Practice Address - Country:US
Practice Address - Phone:720-874-3579
Practice Address - Fax:303-341-1283
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01296425Medicaid
CO01296425Medicaid