Individual
SHERYL BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-2511
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-2511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
85759
CO
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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