Healthcare Provider Details

I. General information

NPI: 1538463526
Provider Name (Legal Business Name): DENISE ANN DIERFELDT NNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WOODMEN RD NICU
COLORADO SPRINGS CO
80923-2601
US

IV. Provider business mailing address

2675 TAMORA WAY
COLORADO SPRINGS CO
80919-3570
US

V. Phone/Fax

Practice location:
  • Phone: 719-571-3276
  • Fax:
Mailing address:
  • Phone: 719-598-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number93126
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: