Individual
VELVET JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 S CAMINO DEL RIO STE 102, DURANGO, CO 81301-6856
(970) 828-3030
(970) 247-0221
Mailing address
450 S CAMINO DEL RIO STE 102, DURANGO, CO 81301-6856
(970) 828-3030
(970) 247-0221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1623855
CO
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
1623855
CO
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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