Individual
MR. EDWARD MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
816 S 5TH ST STE B, MONTROSE, CO 81401-5765
(970) 249-3322
(970) 240-7976
Mailing address
300 S NEVADA AVE, MONTROSE, CO 81401-4273
(970) 249-7751
(970) 249-5029
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0994430
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0994430
STATE LICENSE
CO
Enumeration date
02/05/2019
Last updated
02/05/2019
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