Organization
HAVENS FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA LYNN HEAD NP (NURSE PRACTIONER)
(719) 276-3211
Entity
Organization
Contact information
Practice address
109 LATIGO LN, SUITE C, CANON CITY, CO 81212-8112
(719) 276-3211
(719) 276-3011
Mailing address
1304 CHINOOK LN, PUEBLO, CO 81001-1851
(719) 544-5622
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
98310
CO
Other
Enumeration date
03/29/2007
Last updated
08/22/2020
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