Organization
PINE RIVER HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY BROOKER CNP (OWNER, NURSE PRACTITIONER)
(970) 884-5173
Entity
Organization
Contact information
Practice address
480 WOLVERINE DR, #2B, BAYFIELD, CO 81122-9653
(970) 884-5173
(970) 884-0123
Mailing address
480 WOLVERINE DR, #2B, BAYFIELD, CO 81122-9653
(970) 884-5173
(970) 884-0123
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
174732
CO
363LA2200X
Adult Health Nurse Practitioner
174732
CO
363LP2300X
Primary Care Nurse Practitioner
174732
CO
363LW0102X
Women's Health Nurse Practitioner
174732
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982704441
INDIVIDUAL NPI
CO
Enumeration date
10/08/2009
Last updated
10/08/2009
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