MEDICARE: LAMIJA QUINONEZ NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	F01230508	CO
2	363LF0000X	Family Nurse Practitioner	APN.0998364.NP	CO

General Provider Information

NPI Number	:	1316651540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMIJA QUINONEZ NP

Provider Business Mailing Address
First Line	:	2997 BROADMOOR VALLEY RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4405
Country	:	US
Telephone Number	:	303-881-0792
Fax Number	:	720-792-9743

Provider Business Practice Location Address
First Line	:	2997 BROADMOOR VALLEY RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4405
Country	:	US
Telephone Number	:	303-881-0792
Fax Number	:	720-792-9743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	08/24/2024

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