| NPI | 1902214679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEANN HARDING Member 970-396-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4673) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-08-06 |