Provider Information for 1700326881
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YAKITTA RENFROE
Sex: Female
NPI: 1700326881
Last Updated: 2021-06-27
Certification Date: 2021-06-27
Certification Date: 2021-06-27
Details
Name | Value | ||||||||
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NPI | 1700326881 | ||||||||
Enumeration Date | 2017-03-08 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 3210 E WOODMEN RD STE 100 COLORADO SPRINGS, CO 80920-3591 United States Phone: 609-442-9722 | Fax:719-960-3286 | ||||||||
Primary Practice Address | 3210 E WOODMEN RD STE 110 COLORADO SPRINGS, CO 80920-3591 United States Phone: 609-442-9722 | Fax:719-960-3286 | ||||||||
Secondary Practice Address(es) | 265 S HARLAN ST | ||||||||
Health Information Exchange |
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