Healthcare Provider Details

I. General information

NPI: 1164719464
Provider Name (Legal Business Name): PHYLLIS ANN L'ESTRANGE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PHYLLIS ANN PAGLIARO

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-5646
  • Fax: 719-776-8050
Mailing address:
  • Phone: 719-776-5646
  • Fax: 719-776-8050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0997029-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: