| NPI | 1275392904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL KRUEGER Owner/Authorized Official 719-272-1455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |