Individual
PETER HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 NORTH AVE, GRAND JUNCTION, CO 81501-6428
(970) 241-0731
Mailing address
1381 17 1/2 RD, FRUITA, CO 81521-9222
(970) 858-9575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
213964-4405
UT
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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