Organization
COUNTY LINE HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY CASPER MSN-FNP (OWNER)
(719) 688-9962
Entity
Organization
Contact information
Practice address
36053 US HIGHWAY 287, WILEY, CO 81092-9702
(719) 688-9962
Mailing address
36053 US HIGHWAY 287, WILEY, CO 81092-9702
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
12/09/2021
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