Individual
BRANDY AMBER STATEZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
110 E ROUTT, PUEBLO, CA 91004
(719) 543-8711
(719) 543-5340
Mailing address
310 COLORADO AVE, PUEBLO, CA 81004
(719) 543-8718
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
178042
CO
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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