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Individual

MS. LISA WHEATON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
70 STAFFORD LN, DELTA, CO 81416-2282
(269) 757-1020
Mailing address
1963 SNEFFELS ST, MONTROSE, CO 81401-6451
(269) 757-1020

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
165123-030
WI
163WE0003X
Emergency Registered Nurse
Primary
4704260397
MI
163WH0200X
Home Health Registered Nurse
RN0204139
CO

Other

Enumeration date
04/27/2013
Last updated
04/27/2013
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