Provider Demographics
NPI:1184164519
Name:WESTERN SLOPE NURSE PRACTITIONERS
Entity type:Organization
Organization Name:WESTERN SLOPE NURSE PRACTITIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:970-749-1544
Mailing Address - Street 1:1013 COUNTY ROAD 300
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8064
Mailing Address - Country:US
Mailing Address - Phone:970-749-1544
Mailing Address - Fax:866-749-0163
Practice Address - Street 1:1013 COUNTY ROAD 300
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-8064
Practice Address - Country:US
Practice Address - Phone:970-749-1544
Practice Address - Fax:866-749-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN-0991787-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty