Individual
REBECCA MARIA BETTY SOURS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2115 STUART AVE, ALAMOSA, CO 81101-2269
(719) 589-8008
Mailing address
9292.5 COUNTY ROAD 12, ANTONITO, CO 81120
(719) 580-4309
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN.0995158-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0995158
CO
Other
Enumeration date
11/15/2019
Last updated
09/11/2024
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