Organization
4 CORNERS CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA RENSNER NP (CPNP)
(970) 335-9678
Entity
Organization
Contact information
Practice address
555 RIVERGATE STE B1-109, DURANGO, CO 81301-7473
(970) 335-9678
Mailing address
555 RIVERGATE STE B1-109, DURANGO, CO 81301-7473
(970) 335-9678
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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