Healthcare Provider Details

I. General information

NPI: 1568628964
Provider Name (Legal Business Name): BARBARA J WALTON RN, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 SAWYER DR
DURANGO CO
81303-3409
US

IV. Provider business mailing address

PO BOX 140
DURANGO CO
81302-0140
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-5702
  • Fax: 970-247-9126
Mailing address:
  • Phone: 970-247-5702
  • Fax: 970-247-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number114503
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: