Provider Demographics
NPI:1497262109
Name:BURGESS, YURENA PRIETO CORUJO (MSN)
Entity Type:Individual
Prefix:
First Name:YURENA
Middle Name:PRIETO CORUJO
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:YURENA
Other - Middle Name:
Other - Last Name:PRIETO CORUJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AG-ACNP, BC
Mailing Address - Street 1:2102 UNIVERSITY PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3678
Mailing Address - Country:US
Mailing Address - Phone:719-249-3199
Mailing Address - Fax:
Practice Address - Street 1:2102 UNIVERSITY PARK BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3678
Practice Address - Country:US
Practice Address - Phone:719-249-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO994661363LA2100X, 363LF0000X, 363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily