Healthcare Provider Details
I. General information
NPI: 1104895481
Provider Name (Legal Business Name): NICOLE L PINKERTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/17/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 S CAMINO DEL RIO B2
DURANGO CO
81303-6826
US
IV. Provider business mailing address
70 CLEAR CREEK LOOP
DURANGO CO
81301-8101
US
V. Phone/Fax
- Phone: 970-259-0701
- Fax: 970-259-0109
- Phone: 970-259-0701
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 39575 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | CDRH.0039575 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: