| NPI | 1083312912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE ERIN DOUGLAS Pediatric Nurse Practitioner 719-251-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-10-05 |