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General NPI Number Information
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NPI Number | 1326290750
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Entity Type | Organization
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Legal Business Name | CONEJOS COUNTY PUBLIC HEALTH AND NURSING SERVICES
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 19023 HWY 285 SOUTH
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City | LA JARA
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State | CO
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Zip | 81140
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Country | US
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Telephone | 719-274-4307
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Fax | 719-274-4309
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Provider Business Mailing Address
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Address Line | PO BOX 157 6683 COUNTY RD 13
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City | CONEJOS
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State | CO
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Zip | 81129
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Country | US
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Telephone | 719-274-4307
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Fax | 719-274-4309
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DENISE C JIRON
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Credential |
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Telephone | 719-274-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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