| NPI | 1689012023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRIANN HANCE Owner 719-358-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 99681) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2022-07-21 |