NPI 1932755972

Jack Walsh

Practitioner Registered Nurse Fairplay, CO

Practice location

Address: 825 Clark Street Unit a, Fairplay, CO 80440
Phone: (719) 836-4154

Registered specialties

Registered Nurse Primary

Nursing Service Providers Taxonomy 163W00000X Licence 1646960 (CO)

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Registry record

NPI: 1932755972
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Aug 2019
Record last updated: 15 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.