Marilyn Cieszykowski, NP

Individual provider Active NPI Family Nurse Practitioner · Dolores, CO

NPI 1700875804 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1700875804
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
17661 (CO)
Practice address
507 Central Ave
Dolores, CO 81323-0908
Phone
(970) 882-7221
Fax
(970) 882-4243
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17661COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley-Wide Health Systems, Inc. Past Accepting new patients
Dolores Medical Center PC Past Accepting new patients
Dolores Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17661 CO Yes

Addresses

Primary practice location

507 Central Ave
Dolores, CO 81323-0908

Mailing address

PO Box 1251
Dolores, CO 81323-1251
Phone (970) 882-7221

Other providers in Dolores, CO

All providers in Dolores, CO · Family Nurse Practitioner in Colorado

Sources for this page

Verify at the official NPI Registry.