Healthcare Provider Details

I. General information

NPI: 1649937434
Provider Name (Legal Business Name): RAYNA JEAN RAMIREZ CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 11/29/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 E WOODMEN RD STE 115
COLORADO SPRINGS CO
80923-2603
US

IV. Provider business mailing address

2562 RAYWOOD VW APT 1411
COLORADO SPRINGS CO
80920-7789
US

V. Phone/Fax

Practice location:
  • Phone: 719-319-3873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1678401
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0106162
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0997137
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: