Healthcare Provider Details

I. General information

NPI: 1811249345
Provider Name (Legal Business Name): CATHERINE MARIE PIERCE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE M LANDGRAF PA-C

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

PO BOX 5693
DENVER CO
80217-5693
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-8040
  • Fax: 719-776-3599
Mailing address:
  • Phone: 303-306-4576
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0003557
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: