Individual
OPAL STALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
106 W NORTH ST, CORTEZ, CO 81321-3119
(970) 565-3056
(970) 565-0647
Mailing address
12550 ROAD 33.75, MANCOS, CO 81328-8102
(970) 565-8882
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
49634
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07496342
—
CO
Enumeration date
03/06/2007
Last updated
07/09/2007
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