Provider Demographics
NPI:1831814953
Name:ABUNDANCE HEALTH CARE
Entity type:Organization
Organization Name:ABUNDANCE HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:DR
Authorized Official - First Name:LA TASHA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:BRUNER-HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:720-266-0544
Mailing Address - Street 1:8970 APRIL DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7354
Mailing Address - Country:US
Mailing Address - Phone:720-266-0544
Mailing Address - Fax:
Practice Address - Street 1:3630 SINTON RD STE 320
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5070
Practice Address - Country:US
Practice Address - Phone:720-266-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center