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General NPI Number Information
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NPI Number | 1538525639
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Entity Type | Individual
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Provider Name | TINA MARIE GEHRKE FNP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 715 N CASCADE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-3289
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Country | US
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Telephone | 719-471-9891
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Fax | 719-471-4493
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Provider Business Mailing Address
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Address Line | 8540 SCARBOROUGH DR STE 370
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7519
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Country | US
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Telephone | 719-358-8270
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Fax | 719-358-8299
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0991756-NP
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License Number State | CO
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