Individual
MRS. VERNICE ANN R BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
2201 SAN JUAN AVE, LA JUNTA, CO 81050-3323
(719) 384-8181
(719) 384-4872
Mailing address
2201 SAN JUAN AVE, LA JUNTA, CO 81050-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1565
CO
Other
Enumeration date
04/03/2007
Last updated
02/06/2008
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