Tafoya Family Practice Llc | |
416 Colorado Ave Pueblo CO 81004-2011 | |
(719) 924-9128 | |
Not Available |
Full Name | Tafoya Family Practice Llc |
---|---|
Speciality | Family Medicine |
Location | 416 Colorado Ave, Pueblo, Colorado |
Authorized Official Name and Position | Jesusita Elvira Tafoya (PROVIDER/DIRECTOR) |
Authorized Official Contact | 7194065291 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tafoya Family Practice Llc 416 Colorado Ave Pueblo CO 81004-2011 Ph: (719) 924-9128 | Tafoya Family Practice Llc 416 Colorado Ave Pueblo CO 81004-2011 Ph: (719) 924-9128 |
NPI Number | 1275210759 |
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Provider Enumeration Date | 06/28/2023 |
Last Update Date | 06/28/2023 |
Medicare PECOS PAC ID | 4981049673 |
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Medicare Enrollment ID | O20240416003566 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275210759 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jesusita Elvira Tafoya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225543945 PECOS PAC ID: 6204173354 Enrollment ID: I20190128001099 |
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