Provider Demographics
NPI:1720318421
Name:SPECIALISTS IN WOMEN'S CARE PC
Entity Type:Organization
Organization Name:SPECIALISTS IN WOMEN'S CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PINKERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-650-6001
Mailing Address - Street 1:555 S CAMINO DEL RIO
Mailing Address - Street 2:B2
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6826
Mailing Address - Country:US
Mailing Address - Phone:970-259-0701
Mailing Address - Fax:970-259-0109
Practice Address - Street 1:555 S CAMINO DEL RIO
Practice Address - Street 2:B2
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6826
Practice Address - Country:US
Practice Address - Phone:970-259-0701
Practice Address - Fax:970-259-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39575207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO66406323Medicaid
H49099OtherUPIN
CO6467540001Medicare NSC
H49099OtherUPIN