| NPI | 1497397657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY KAY MOLINAR Family Nurse Practitioner 719-778-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-01-06 |