Healthcare Provider Details

I. General information

NPI: 1790456820
Provider Name (Legal Business Name): PATRICIA MARIA BARRAZA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA MARIA BERNADAC FNP

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

PO BOX 17503
DENVER CO
80217-0503
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-5000
  • Fax:
Mailing address:
  • Phone: 877-346-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997669-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: