Individual
MRS. CAROLE NASRALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27B TALISMAN DR UNIT 3, PAGOSA SPRINGS, CO 81147-7914
(970) 372-0456
(970) 731-9922
Mailing address
PO BOX 1328, DURANGO, CO 81302-1328
(970) 335-2342
(970) 335-2438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40509
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
000N5453
PROVIDER MEDICAID NUMBER
NM
05
—
61453251
—
CO
01
—
8HBL75
MEDICARE NUMBER
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
06/29/2006
Last updated
02/09/2026
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