Healthcare Provider Details

I. General information

NPI: 1154889608
Provider Name (Legal Business Name): OPEN ARMS PAIN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 505
COLORADO SPRINGS CO
80909-5372
US

IV. Provider business mailing address

685 CITADEL DR E STE 505
COLORADO SPRINGS CO
80909-5372
US

V. Phone/Fax

Practice location:
  • Phone: 719-265-4412
  • Fax: 719-888-1739
Mailing address:
  • Phone: 719-265-4412
  • Fax: 719-888-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MISS VICTORIA LYNN KROHN
Title or Position: CMO
Credential: NURSE PRACTITIONER
Phone: 719-313-7656