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General NPI Number Information
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NPI Number | 1114003399
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Entity Type | Individual
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Provider Name | TRACY ANN PAESCHKE MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 1633 MEDICAL CENTER POINT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907
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Country | US
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Telephone | 719-203-2603
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Fax | 279-201-6476
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Provider Business Mailing Address
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Address Line | 15954 JACKSON CREEK PKWY STE B #435
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City | MONUMENT
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State | CO
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Zip | 80132-8532
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Country | US
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Telephone | 719-203-2603
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Fax | 279-201-6476
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | CDHR.0041162
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License Number State | CO
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