Provider Demographics
NPI:1407631575
Name:FIELDING, BOH
Entity Type:Individual
Prefix:
First Name:BOH
Middle Name:
Last Name:FIELDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BOH
Other - Middle Name:
Other - Last Name:GEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSC
Mailing Address - Street 1:20608 E 49TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20608 E 49TH DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7627
Practice Address - Country:US
Practice Address - Phone:720-672-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04VDRY251E00000X
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health