Healthcare Provider Details

I. General information

NPI: 1639168214
Provider Name (Legal Business Name): VIRGINIA M QUIROZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 MEDICAL CENTER PT
COLORADO SPRINGS CO
80907-5700
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 719-538-2900
  • Fax: 719-471-8841
Mailing address:
  • Phone: 719-447-1000
  • Fax: 719-471-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0002989
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: