Provider Demographics
NPI:1386966463
Name:TUFFIELD, DEBORAH SUE-PERANTONI (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUE-PERANTONI
Last Name:TUFFIELD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:SUE-PERANTONI
Other - Last Name:TUFFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4863 N NEVADA AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3951
Mailing Address - Country:US
Mailing Address - Phone:719-255-8001
Mailing Address - Fax:719-255-8044
Practice Address - Street 1:4863 N NEVADA AVE STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-255-8001
Practice Address - Fax:719-255-8044
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP10185363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00837521Medicaid