Basic Information
Provider Information | |||||||||
NPI: | 1760423024 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BELFIGLIO | ||||||||
FirstName: | ANN | ||||||||
MiddleName: | M | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | R.N. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MCCLOSKEY | ||||||||
OtherFirstName: | ANN | ||||||||
OtherMiddleName: | R. | ||||||||
OtherNamePrefix: | MISS | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | R.N. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 5015 LANGDALE WAY | ||||||||
Address2: |   | ||||||||
City: | COLORADO SPRINGS | ||||||||
State: | CO | ||||||||
PostalCode: | 809067673 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7195761014 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1650 COCHRANE CIR | ||||||||
Address2: | ATTN:MCXE-PCC-PEDS | ||||||||
City: | FORT CARSON | ||||||||
State: | CO | ||||||||
PostalCode: | 809134603 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7195244037 | ||||||||
FaxNumber: | 7195267673 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/09/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | X | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | RN-113895 | CO | Y |   | Nursing Service Providers | Registered Nurse | Pediatrics |
No ID Information.