Individual
NATIKA DIDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1026 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 545-2746
(719) 545-4100
Mailing address
1304 CHINOOK LN, PUEBLO, CO 81001-1851
(719) 545-2746
(719) 545-4100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.1622971
CO
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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