MEDICARE: TERESA YAMBO

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.1001348-NP	CO

General Provider Information

NPI Number	:	1497618193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA YAMBO

Provider Business Mailing Address
First Line	:	2918 BEACON ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-9208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2918 BEACON ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-9208
Country	:	US
Telephone Number	:	719-629-7723
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ TERESA YAMBO ” Practice Location

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