Organization Name: | SAGUARO FAMILY CLINIC |
NPI Number: | 1063599256 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GAIL LADEAN CROSS (PRESIDENT) |
Mailing Address: | 1189 S Perry St Suite 220 Castle Rock |
State: | CO US |
Postal Code: | 801041958 |
Phone Number: | 3036888108 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 09/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 57204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |