Individual
RAJANI SURESHKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 N GRAND AVE, PUEBLO, CO 81003-2867
(719) 766-8511
Mailing address
805 VILLAGE CT APT A, PUEBLO, CO 81001-5113
(719) 506-0035
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1000753
CO
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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