Individual
HANNAH MIRZAKHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
311 W 14TH ST, PUEBLO, CO 81003-2705
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2781
(719) 595-7585
(719) 595-7589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C2-0023894
DE
207R00000X
Internal Medicine Physician
Primary
TL.0007345
CO
Other
Enumeration date
04/30/2018
Last updated
06/18/2021
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