Healthcare Provider Details

I. General information

NPI: 1770447419
Provider Name (Legal Business Name): BROOKE CRONISTER EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 THREE SPRINGS BLVD
DURANGO CO
81301-9033
US

IV. Provider business mailing address

150 MERCURY VILLAGE DR
DURANGO CO
81301-8955
US

V. Phone/Fax

Practice location:
  • Phone: 970-252-3200
  • Fax:
Mailing address:
  • Phone: 970-335-2248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License NumberQ251549
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: