Healthcare Provider Details

I. General information

NPI: 1164245171
Provider Name (Legal Business Name): RAMONA KAY FONSECA-NAVA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 THREE SPRINGS BLVD
DURANGO CO
81301-8296
US

IV. Provider business mailing address

600 DOVE RANCH RD
BAYFIELD CO
81122-9868
US

V. Phone/Fax

Practice location:
  • Phone: 970-764-2100
  • Fax:
Mailing address:
  • Phone: 970-880-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0200862
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: