Provider Demographics
NPI:1669808325
Name:HERRERA, SOCORRO ALICIA (RN-C)
Entity type:Individual
Prefix:
First Name:SOCORRO
Middle Name:ALICIA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:RN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0405 CASTLE CREEK ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611
Mailing Address - Country:US
Mailing Address - Phone:970-920-5420
Mailing Address - Fax:970-920-5419
Practice Address - Street 1:0405 CASTLE CREEK ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611
Practice Address - Country:US
Practice Address - Phone:970-920-5420
Practice Address - Fax:970-920-5419
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO168384163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient