Healthcare Provider Details

I. General information

NPI: 1215067434
Provider Name (Legal Business Name): SOUTHWEST WOMENS HEALTH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 RIVERGATE UNIT 210
DURANGO CO
81301-7488
US

IV. Provider business mailing address

PO BOX 15000
DURANGO CO
81302-8901
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-0042
  • Fax: 970-259-8837
Mailing address:
  • Phone: 970-259-2525
  • Fax: 970-247-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN ZINK
Title or Position: OWNER
Credential: CNP
Phone: 970-247-0042