Individual
KALI MAE MENDOZA-WERNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1100 CARSON AVE, SUITE 201, LA JUNTA, CO 81050-2751
(719) 383-5900
(719) 383-6533
Mailing address
711 BARNES AVE, LA JUNTA, CO 81050-2138
(719) 384-5446
(719) 384-5672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
942
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840706945168
ROCKY MOUNTAIN HEALTH PLA
CO
01
—
P00231959
TRAVELERS MEDICARE
—
Enumeration date
10/24/2005
Last updated
04/06/2018
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