Individual
KENNETH HURD PICILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1311 N MILDRED RD, CORTEZ, CO 81321-2231
(970) 565-6666
Mailing address
PO BOX 1589, CORTEZ, CO 81321-1589
(801) 557-3421
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
174761
CO
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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