Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | NP1070 | CO |
NPI | 1144501230 |
---|---|
Provider Name | Laurale Marie Cross |
First Address | Glenwood Springs, CO 81601-4227 |
Second Address | Glenwood Springs, CO 81601-4227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2011 |
Last Update Date | 01/09/2011 |