Healthcare Provider Details

I. General information

NPI: 1538525639
Provider Name (Legal Business Name): TINA MARIE GEHRKE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 505
COLORADO SPRINGS CO
80909-5372
US

IV. Provider business mailing address

685 CITADEL DR E STE 505
COLORADO SPRINGS CO
80909-5372
US

V. Phone/Fax

Practice location:
  • Phone: 719-265-4412
  • Fax: 719-888-1739
Mailing address:
  • Phone: 719-265-4412
  • Fax: 719-888-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberAPN.0991756-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0991756-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0991756-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: