NPI 1144832981 · live from the CMS NPI Registry
4 Corners Children'S Clinic
Nurse Practitioner, Pediatrics in Durango, CO. National Provider Identifier 1144832981, active.
NPI record
| NPI | 1144832981 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 555 Rivergate Ste B1-109, Durango, CO 81301 |
| Practice phone | 970-335-9678 |
| Enumerated | August 22, 2020 |
| Last updated | August 22, 2020 |
| Authorized official | Jessica Rensner, Cpnp |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.