Healthcare Provider Details

I. General information

NPI: 1679490825
Provider Name (Legal Business Name): BLUESPRIG PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 PROSPECT PARK WAY STE 110
FORT COLLINS CO
80525-9707
US

IV. Provider business mailing address

1613 PROSPECT PARK WAY STE 110
FORT COLLINS CO
80525-9707
US

V. Phone/Fax

Practice location:
  • Phone: 970-297-7704
  • Fax:
Mailing address:
  • Phone: 970-297-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MISS ANDREA GISELLE PEDROZA
Title or Position: BEHAVIOR TECHNICIAN
Credential:
Phone: 720-692-3605