Individual
MS. CAROL P IBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, RXN, APRN
Contact information
Practice address
605 E MIAMI RD, MONTROSE, CO 81401
(970) 249-9694
(970) 249-2955
Mailing address
PO BOX 1208, MONTROSE, CO 81402-1208
(970) 252-3200
(970) 252-3208
Taxonomy
Speciality
Code
Description
License number
State
364SP0812X
Community Psychiatric/Mental Health Clinical Nurse Specialist
Primary
46632
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-0561224
TAX ID
CO
Enumeration date
07/12/2006
Last updated
08/28/2012
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