| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 06/28/2023 |
| Last Update Date | 06/28/2023 |
| Medicare PECOS PAC ID | 4981049673 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225543945 PECOS PAC ID: 6204173354 Enrollment ID: I20190128001099 |
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