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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CANON PROFESSIONAL WELLNESS CLINIC LLC

Active Organization

Primary Care Nurse Practitioner · CANON CITY, CO

Registration Details

NPI Number
1780384560
Provider Type
Organization
NPI Issued
Mar 9, 2023 (3.1217652385156 yrs)
Last Updated
Feb 19, 2024

Practice Information

Address
730 MACON AVE
CANON CITY, CO, 812123314
Browse CO providers · Browse ZIP 81212
Phone
7192751618
Primary Specialty
Primary Care Nurse Practitioner
363LP2300X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.