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Individual

BARBARA A PIVONKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1115 2ND ST, FORT LUPTON, CO 80621-1745
(303) 857-2771
(720) 322-9434
Mailing address
203 S ROLLIE AVE, BILLING DEPT - CREDENTIALIST, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0002434-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07882874
CO
Enumeration date
06/10/2005
Last updated
06/29/2016
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