Individual
DYAN I ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8900 INDEPENDENCE WAY, ALAMOSA, CO 81101-9412
(719) 588-0786
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 587-1038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
123420
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25379810
—
CO
Enumeration date
08/29/2008
Last updated
08/29/2008
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