Basic Information
| Provider Information | |||||||||
| NPI: | 1316280993 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VETTER | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4105 BRIARGATE PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809203484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193642800 | ||||||||
| FaxNumber: | 5809771857 | ||||||||
| Practice Location | |||||||||
| Address1: | 4105 BRIARGATE PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809203484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193642800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2013 | ||||||||
| LastUpdateDate: | 12/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 32804 | OK | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | DR.0058837 | CO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.