Provider Demographics
NPI:1205813292
Name:KAUFMANN, DEBORAH M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:M
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1177
Mailing Address - Country:US
Mailing Address - Phone:719-598-9446
Mailing Address - Fax:719-598-5734
Practice Address - Street 1:3030 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909
Practice Address - Country:US
Practice Address - Phone:719-598-9446
Practice Address - Fax:719-598-5734
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2079363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55689582Medicaid
COQ42100Medicare UPIN
CO55689582Medicaid