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Individual

KERRI BAGNALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
402 N TEJON ST, SUITE 200, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
(719) 227-0840
Mailing address
402 N TEJON ST, SUITE 200, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
(719) 227-0840

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DR45089
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11820314
CO
Enumeration date
08/30/2005
Last updated
03/01/2017
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