Healthcare Provider Details

I. General information

NPI: 1952705121
Provider Name (Legal Business Name): SUE ANNE ZHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 HARTSEL DR
COLORADO SPRINGS CO
80920-4165
US

IV. Provider business mailing address

1650 DUBLIN BLVD APT 265
COLORADO SPRINGS CO
80918-8369
US

V. Phone/Fax

Practice location:
  • Phone: 719-590-1099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number20305
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: