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Organization

COLORADO STATE UNIVERSITY PUEBLO

Active
Other names
Wolfpack Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROLYN KAY DAUGHERTY FNP-BC (ASSISTANT DEAN)
(719) 549-2830
Entity
Organization

Contact information

Practice address
2200 BONFORTE BLVD # 172, PUEBLO, CO 81001-4901
(719) 549-2830
(719) 549-2646
Mailing address
2200 BONFORTE BLVD # 172, PUEBLO, CO 81001-4901
(719) 549-2830
(719) 549-2646

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
10/30/2023
Last updated
10/30/2023
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