KATELYN MIRANDA DEVERAUX

PUEBLO, CO
NPI1386225522
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: CO  TL.0008870)
Additional Taxonomies207Q00000X Family Medicine
(Licence: CO  TL.0008870)
208D00000X General Practice
(Licence: CO  DR.0069707)
Enumeration Date2021-04-19
Last Update Date2023-04-17
Business Address
KATELYN MIRANDA DEVERAUX
902 LAKEVIEW AVE
PUEBLO, CO 81004-3597
Phone number: 719-557-5855
Mailing Address
KATELYN MIRANDA DEVERAUX
902 LAKEVIEW AVE
PUEBLO, CO 81004-3597
Phone number: