Individual
TSOMORLOG AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
Mailing address
7758 HIGH GATE DR, FOUNTAIN, CO 80817-4232
(414) 364-4156
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0998362-NP
CO
363LA2100X
Acute Care Nurse Practitioner
APN.0998362-NP
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0998362-NP
CO
Other
Enumeration date
01/12/2023
Last updated
02/23/2026
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