Individual
SUE MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4863 N NEVADA AVE, COLORADO SPRINGS, CO 80918-3951
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041206751/209002498
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
445636YKRD
MEDICARE NUMBER
CO
Enumeration date
11/01/2006
Last updated
11/12/2015
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