MEDICARE: PAMELA DOBYNS FNP

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	363LF0000X	Family Nurse Practitioner	APN.0996927-NP	CO
2	207Q00000X	Family Medicine Physician	APN.0996927-NP	CO

General Provider Information

NPI Number	:	1932867231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA DOBYNS FNP

Provider Business Mailing Address
First Line	:	15675 CLEARWATER DR
Second Line	:
City	:	ELBERT
State	:	CO
Zip	:	80106-8846
Country	:	US
Telephone Number	:	719-229-1875
Fax Number	:

Provider Business Practice Location Address
First Line	:	2739 E LAS VEGAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-1594
Country	:	US
Telephone Number	:	719-390-2000
Fax Number	:

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

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	09/26/2022

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