Provider Demographics
NPI:1255430088
Name:ESSENTIAL WOMENS CARE, P.C.
Entity type:Organization
Organization Name:ESSENTIAL WOMENS CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LUCILLE
Authorized Official - Last Name:ROPER-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-941-8266
Mailing Address - Street 1:4545 E 9TH AVE
Mailing Address - Street 2:506
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3901
Mailing Address - Country:US
Mailing Address - Phone:720-941-8266
Mailing Address - Fax:720-941-8337
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:506
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:720-941-8266
Practice Address - Fax:720-941-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08577013Medicaid
CO08577013Medicaid