Individual
DR. ELISABETH SUSAN VANSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2828 INTERNATIONAL CIR, SUITE 140, COLORADO SPRINGS, CO 80910-3127
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101017747
MI
208000000X
Pediatrics Physician
DR.0049778
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64474216
—
CO
01
—
COA109806
MEDICARE NUMBER
CO
Enumeration date
07/01/2008
Last updated
09/05/2023
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