Healthcare Provider Details

I. General information

NPI: 1144141144
Provider Name (Legal Business Name): CORINNA LYNN RAMLOGAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N GRAND AVE STE 240
PUEBLO CO
81003-2731
US

IV. Provider business mailing address

1600 N GRAND AVE STE 240
PUEBLO CO
81003-2731
US

V. Phone/Fax

Practice location:
  • Phone: 719-295-2305
  • Fax: 719-295-2320
Mailing address:
  • Phone: 719-295-2305
  • Fax: 719-295-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN.1002186-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002186-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: