Individual
VANESSA K BECERRIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 COLORADO AVE, PUEBLO, CO 81004-2006
(719) 543-8711
(719) 543-0171
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 585-3057
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
AP2422
MA
363A00000X
Physician Assistant
Primary
PA.0003708
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96734281
—
CO
Enumeration date
10/11/2007
Last updated
09/01/2021
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