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Organization
SOCO PRIMARY CARE CLINIC
Active
Organization
SOCO PRIMARY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LYNN BETTS NP, AGNP-C (PRESIDENT, AUTHORIZED OFFICIAL)
(719) 582-1898
Entity
Organization
Contact information
Practice address
1310 FORTINO BLVD STE D, PUEBLO, CO 81008-2076
(719) 582-1898
(719) 621-4098
Mailing address
1310 FORTINO BLVD, PUEBLO, CO 81008-2075
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
04/30/2020
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