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Individual

MRS. RENAE TABIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
569 32 RD STE 12, GRAND JUNCTION, CO 81504
(970) 523-3544
(970) 434-3422
Mailing address
300 S NEVADA AVE, MONTROSE, CO 81401-4273
(970) 249-7751
(970) 249-5029

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0002974
CO
363A00000X
Physician Assistant
PA10005322
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
95084517
CO
Enumeration date
12/21/2007
Last updated
06/27/2018
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