| NPI | 1386989200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY K FANCHER CFO/COO 970-482-0198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 164W00000X Licensed Practical Nurse | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2022-01-14 |