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STARLA SECREST PAC

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1609812643

Individual Registrant:
 STARLA  SECREST PAC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
100 PIONEERS MEDICAL CENTER DR  MEEKER, CO 81641-3181 US
Tel: 970-878-4014  Fax: 970-878-0019

Contact information for business:
100 PMC DR  MEEKER, CO 81641-3181 US
Tel: 970-878-4014  Fax: 970-878-0019

Registration Information:
NPI: 1609812643
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CO1495

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
78105544CO05




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