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General NPI Number Information
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NPI Number | 1740249747
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Entity Type | Individual
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Provider Name | SHIRLEY ELAINE NIX
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 615 FAIRHURST ST
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City | STERLING
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State | CO
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Zip | 80751-4564
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Country | US
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Telephone | 970-521-3223
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Fax | 970-521-3266
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Provider Business Mailing Address
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Address Line | 1441 N 12TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-2837
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Country | US
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Telephone | 602-495-4577
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Fax | 602-417-3549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34136
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License Number State | CO
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