Mallorye Ann Bane, RN
Individual provider Active NPI Registered Nurse · Cortez, CO
NPI 1962028910 · NPPES record last updated Jun 24, 2020
Key facts
- NPI
- 1962028910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN.1665815 (CO)
- Practice address
- 106 W North St
Cortez, CO 81321-3119 - Phone
- (970) 565-3056
- Fax
- (970) 565-0647
- NPI assigned
- Jun 24, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.1665815 | CO | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montezuma County Health Department | Past |
Accepting new patients | |
| Montezuma County Health Department | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | RN.1665815 | CO | |
| Registered Nurse | 163W00000X | RN.1665815 | CO | Yes |
Addresses
Primary practice location
106 W North St
Cortez, CO 81321-3119
Mailing address
106 W North St
Cortez, CO 81321-3119
Phone (970) 565-3056
Other providers in Cortez, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.