Healthcare Provider Details

I. General information

NPI: 1134756182
Provider Name (Legal Business Name): RACHEL RENEE MOSER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL RENEE KISTEMAKER DO

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3127
US

IV. Provider business mailing address

2828 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3127
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-5700
  • Fax:
Mailing address:
  • Phone: 719-632-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMSDR.0000011
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: