Healthcare Provider Details

I. General information

NPI: 1760330096
Provider Name (Legal Business Name): BARBRA RACHEL ROLDAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 GALLEY RD
COLORADO SPRINGS CO
80909-4413
US

IV. Provider business mailing address

923 TARI DR
COLORADO SPRINGS CO
80921-2256
US

V. Phone/Fax

Practice location:
  • Phone: 719-355-1172
  • Fax:
Mailing address:
  • Phone: 626-676-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999759-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: