Provider Demographics
NPI:1164719464
Name:L'ESTRANGE, PHYLLIS ANN (NP)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:ANN
Last Name:L'ESTRANGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:ANN
Other - Last Name:PAGLIARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 N NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6819
Mailing Address - Country:US
Mailing Address - Phone:719-776-5646
Mailing Address - Fax:719-776-8050
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-776-5646
Practice Address - Fax:719-776-8050
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997029-NP363LA2200X, 363L00000X
NY305697363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000222364Medicaid
NYA400130244Medicare PIN