Healthcare Provider Details

I. General information

NPI: 1629138813
Provider Name (Legal Business Name): CHRISTEN FISCELLA KUTZ DHSC, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 DELMONICO DR STE 102
COLORADO SPRINGS CO
80919-2243
US

IV. Provider business mailing address

5825 DELMONICO DR STE 102
COLORADO SPRINGS CO
80919-2243
US

V. Phone/Fax

Practice location:
  • Phone: 303-381-0929
  • Fax: 303-381-1566
Mailing address:
  • Phone: 303-381-0929
  • Fax: 303-381-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052445
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: