Provider Demographics
NPI:1639168214
Name:QUIROZ, VIRGINIA M (NP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:QUIROZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1633 MEDCIAL CENTER POINT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907
Mailing Address - Country:US
Mailing Address - Phone:719-447-1000
Mailing Address - Fax:719-471-8841
Practice Address - Street 1:1633 MEDICAL CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5700
Practice Address - Country:US
Practice Address - Phone:719-538-2900
Practice Address - Fax:719-471-8841
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0002989363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59228334Medicaid
CO59228334Medicaid
COP67755Medicare UPIN