Individual
MRS. DIANE ELLEN ANTIONETTE GARGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
899 MIRCOS ST, ERIE, CO 80516-5411
(720) 472-1504
Mailing address
899 MIRCOS ST, ERIE, CO 80516-5411
(720) 472-1504
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN-184415
CO
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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