Individual
KAELA MASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-0511
Mailing address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-0511
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0007112
CO
Other
Enumeration date
04/21/2021
Last updated
08/02/2022
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