Individual
MRS. DIANE AGNES MRKVICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
360 PEAK ONE DRIVE, SUITE 230, FRISCO, CO 80443
(970) 668-9195
Mailing address
PO BOX 2280, 360 PEAK ONE DRIVE SUITE 230, FRISCO, CO 80443-2280
(970) 668-9195
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
74772
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80582834
—
CO
Enumeration date
08/09/2007
Last updated
08/09/2007
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