| Trifecta Family Wellness Llc | |
|
805 Eagleridge Blvd Ste 150 Pueblo CO 81008-2194 | |
| (719) 627-4287 | |
| (719) 220-7658 |
| Full Name | Trifecta Family Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 805 Eagleridge Blvd Ste 150, Pueblo, Colorado |
| Authorized Official Name and Position | Brandie Quick (OWNER) |
| Authorized Official Contact | 7194681569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trifecta Family Wellness Llc 805 Eagleridge Blvd Ste 150 Pueblo CO 81008-2194 Ph: (719) 627-4287 | Trifecta Family Wellness Llc 805 Eagleridge Blvd Ste 150 Pueblo CO 81008-2194 Ph: (719) 627-4287 |
| NPI Number | 1215667936 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 02/07/2023 |
| Medicare PECOS PAC ID | 8527429828 |
|---|---|
| Medicare Enrollment ID | O20230803000196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215667936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elsie Kathrine Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538519384 PECOS PAC ID: 1759629066 Enrollment ID: I20190806003550 |
| Provider Name | Brandie Quick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558956086 PECOS PAC ID: 9436510732 Enrollment ID: I20230803000346 |
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