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NPI Code Detail

MEDICARE: PATRICIA SALLIE R.N.

MEDICARE: PATRICIA SALLIE R.N.
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
1163W00000XRegistered NurseRN.0165753CO

General Provider Information

NPI Number : 1710379938
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA SALLIE R.N.
Provider Business Mailing Address
First Line : 201 N 6TH ST
Second Line :
City : CANON CITY
State : CO
Zip : 81212-3303
Country : US
Telephone Number : 719-276-7450
Fax Number : 719-276-7451
Provider Business Practice Location Address
First Line : 201 N 6TH ST
Second Line :
City : CANON CITY
State : CO
Zip : 81212-3303
Country : US
Telephone Number : 719-276-7450
Fax Number : 719-276-7451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2015
Last Update Date : 02/25/2015

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Directions to “ PATRICIA SALLIE R.N.” Practice Location

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