MEDICARE: NICOLE ARAGON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	10575	CO

General Provider Information

NPI Number	:	1063816544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ARAGON

Provider Business Mailing Address
First Line	:	2829 NORTH AVE
Second Line	:	SUITE 107
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 NORTH AVE
Second Line	:	SUITE 107
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5368
Country	:	US
Telephone Number	:	970-250-8221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	10/13/2014

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Directions to “ NICOLE ARAGON ” Practice Location

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