Individual
MRS. MARCELLA ANTOINETTE MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1310 FORTINO BLVD STE D, PUEBLO, CO 81008-2076
(719) 582-1898
Mailing address
1310 FORTINO BLVD STE D, PUEBLO, CO 81008-2076
(719) 582-1898
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN.1640139
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0996394-NP
CO
Other
Enumeration date
11/30/2020
Last updated
03/23/2021
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