Provider Demographics
NPI:1760766430
Name:SPRINGFIELD, KAREN SUE (APN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:SPRINGFIELD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9000
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-9000
Mailing Address - Country:US
Mailing Address - Phone:719-553-2201
Mailing Address - Fax:833-216-2047
Practice Address - Street 1:3676 PARKER BLVD STE 260
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2282
Practice Address - Country:US
Practice Address - Phone:719-553-2201
Practice Address - Fax:833-916-2047
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP10300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98725211Medicaid