Provider Demographics
NPI:1093838013
Name:EWERS, TERRI SUE (PA-C)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:SUE
Last Name:EWERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5835 LEHMAN DR
Mailing Address - Street 2:STE 101
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3408
Mailing Address - Country:US
Mailing Address - Phone:719-262-9283
Mailing Address - Fax:719-262-9285
Practice Address - Street 1:2405 RESEARCH PARKWAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-522-1100
Practice Address - Fax:719-522-1138
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical