Provider Demographics
NPI:1538358304
Name:AVABELLA GYNECOLOGY AND WELLNESS INSTITUTE
Entity type:Organization
Organization Name:AVABELLA GYNECOLOGY AND WELLNESS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, MS
Authorized Official - Phone:970-946-9876
Mailing Address - Street 1:450 S CAMINO DEL RIO
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6856
Mailing Address - Country:US
Mailing Address - Phone:970-259-9311
Mailing Address - Fax:800-268-3043
Practice Address - Street 1:450 S CAMINO DEL RIO
Practice Address - Street 2:SUITE 106
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6856
Practice Address - Country:US
Practice Address - Phone:970-259-9311
Practice Address - Fax:866-268-3043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51603261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service