Individual
CAROLINE HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4595
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/01/2009
Last updated
07/02/2009
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