Healthcare Provider Details

I. General information

NPI: 1205487261
Provider Name (Legal Business Name): JAIME LECUYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 DELMONICO DR
COLORADO SPRINGS CO
80919-2251
US

IV. Provider business mailing address

7951 SHOAL CREEK BLVD STE 300
AUSTIN TX
78757-7582
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-7246
  • Fax: 855-592-2816
Mailing address:
  • Phone: 512-584-8404
  • Fax: 855-592-2816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0994849-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: