Individual
DANIEL MIRSHAMSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4312
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1411
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN.0993531-NP
CO
363LF0000X
Family Nurse Practitioner
APN.0993531-NP
CO
Other
Enumeration date
11/13/2017
Last updated
12/21/2022
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