Organization
IGNACIO FAMILY MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIXIE ANN MELTON CNP (CORPORATION PRESIDENT)
(970) 563-9388
Entity
Organization
Contact information
Practice address
115 CEDAR STREET, IGNACIO, CO 81137
(970) 563-9388
Mailing address
PO BOX 707, IGNACIO, CO 81137-0707
(970) 563-9388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
70939
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15555071
—
CO
05
—
60309067
—
CO
Enumeration date
02/29/2008
Last updated
02/29/2008
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