Healthcare Provider Details

I. General information

NPI: 1720318421
Provider Name (Legal Business Name): SPECIALISTS IN WOMEN'S CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
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

555 S CAMINO DEL RIO B2
DURANGO CO
81303-6826
US

V. Phone/Fax

Practice location:
  • Phone: 970-259-0701
  • Fax: 970-259-0109
Mailing address:
  • Phone: 970-259-0701
  • Fax: 970-259-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number39575
License Number StateCO

VIII. Authorized Official

Name: DR. NICOLE L PINKERTON
Title or Position: PRESIDENT
Credential: MD
Phone: 719-650-6001