Individual
DARIO BYUNG SAN ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP/FNP
Contact information
Practice address
410 BENEDICTA AVE, TRINIDAD, CO 81082-2005
(719) 846-4262
(719) 846-3540
Mailing address
PO BOX 481, TRINIDAD, CO 81082
(719) 289-1139
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
0180603
CO
363LA2100X
Acute Care Nurse Practitioner
APN.0991479-NP
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0991479-NP
CO
Other
Enumeration date
10/14/2014
Last updated
04/04/2016
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