Healthcare Provider Details

I. General information

NPI: 1720155021
Provider Name (Legal Business Name): DEBRA ANN ANSHUTZ N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 MEDICAL CENTER PT
COLORADO SPRINGS CO
80907
US

IV. Provider business mailing address

2 S CASCADE AVE STE 140
COLORADO SPRINGS CO
80903-1604
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-5148
  • Fax: 719-570-0601
Mailing address:
  • Phone: 719-866-6568
  • Fax: 719-538-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number86604
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0002014-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: