Individual
IRINA VANCEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3426 LAKE AVE, STE 120, PUEBLO, CO 81004-3877
(719) 561-5264
(719) 561-5272
Mailing address
3426 LAKE AVE, STE 120, PUEBLO, CO 81004-3877
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
46605
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08252866
—
CO
Enumeration date
10/20/2006
Last updated
04/19/2018
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