Individual
DIANA SUE PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2781
(719) 595-7705
Mailing address
2216 LONGHORN DR, PUEBLO, CO 81008-1899
(719) 251-9787
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0997423-NP
CO
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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