Individual
DEBRA M KOEPFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
722 S WAHSATCH AVE, COLORADO SPRINGS, CO 80903-4035
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, STE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
PA.0004453
CO
363AM0700X
Medical Physician Assistant
PA.0004453
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74205030
—
CO
Enumeration date
04/23/2007
Last updated
04/04/2017
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