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Individual

KRYSTAL J HOLDERNESS NAKAMURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2001 LAKE AVE, PUEBLO, CO 81004-3538
(719) 564-5544
Mailing address
2001 LAKE AVE, PUEBLO, CO 81004-3538
(719) 564-5544

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
44146
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26722054
CO
Enumeration date
01/25/2006
Last updated
03/09/2012
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