| Organization Name: | ALAMOSA FOOT AND NAIL CARE MEDICAL SERVICES |
| NPI Number: | 1144631052 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CRYSTAL ANN BIRDSONG (NURSE PRACTITIONER/OWNER) |
| Mailing Address: | 1991 Carroll St Alamosa |
| State: | CO US |
| Postal Code: | 811012003 |
| Phone Number: | 7195894952 |
| Fax Number: | 7195895651 |
| NPI Enumeration Date: | 05/13/2014 |
| NPI Last Update Date: | 05/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 0110549 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |