Organization
STEAMBOAT EP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY NETTLES MSN, RN (CLINICAL DIRECTOR)
(970) 846-6230
Entity
Organization
Contact information
Practice address
1600 MID VALLEY DR, STEAMBOAT SPRINGS, CO 80487-9006
(970) 846-6230
Mailing address
1600 MID VALLEY DR, STEAMBOAT SPRINGS, CO 80487-9006
(970) 846-6230
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972028298
COMMUNITY CLINIC AND EMERGENCY CENTER
CO
Enumeration date
08/08/2017
Last updated
01/24/2019
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