Individual
MARY WINIFRED DAVIS-PRANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 37TH ST, EVANS, CO 80620-1906
(970) 348-1112
(970) 348-1134
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 350-4645
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8244555-4405
UT
363L00000X
Nurse Practitioner
Primary
010221
CO
Other
Enumeration date
08/11/2014
Last updated
02/09/2024
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