Individual
REBECCA D GORANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MERCADO ST STE 202, DURANGO, CO 81301-7307
(970) 764-9400
(970) 764-9449
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
SC
363AS0400X
Surgical Physician Assistant
1902
SC
363AS0400X
Surgical Physician Assistant
Primary
PA.0005954
CO
Other
Enumeration date
02/18/2013
Last updated
05/08/2024
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