Healthcare Provider Details
I. General information
NPI: 1871833657
Provider Name (Legal Business Name): CHRISTINE ANGELA COVELLI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/15/2013
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
228 W RAILROAD AVE
FORT MORGAN CO
80701-2324
US
IV. Provider business mailing address
700 COLUMBINE ST
STERLING CO
80751-3728
US
V. Phone/Fax
- Phone: 970-867-4918
- Fax: 970-867-0878
- Phone: 970-522-3741
- Fax: 970-522-1412
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | RN.0178495 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: