Healthcare Provider Details

I. General information

NPI: 1528821691
Provider Name (Legal Business Name): MARYJEL QUIZON ESPINOZA DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3087 LOOKING GLASS WAY
COLORADO SPRINGS CO
80908-5204
US

IV. Provider business mailing address

3087 LOOKING GLASS WAY
COLORADO SPRINGS CO
80908-5204
US

V. Phone/Fax

Practice location:
  • Phone: 850-226-2133
  • Fax:
Mailing address:
  • Phone: 850-226-2133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999277-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: