Individual
MS. JERRIANN VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
100 W 4TH ST, WALSENBURG, CO 81089-1910
(719) 738-4590
Mailing address
PO BOX 76510, COLORADO SPRINGS, CO 80970-6510
(719) 859-0015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0000939
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73802832
—
CO
Enumeration date
05/22/2008
Last updated
12/18/2018
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