Provider Demographics
NPI:1811740913
Name:VIALPANDO COMPLETE CARE LLC
Entity type:Organization
Organization Name:VIALPANDO COMPLETE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIALPANDO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-C
Authorized Official - Phone:719-502-7031
Mailing Address - Street 1:410 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-3958
Mailing Address - Country:US
Mailing Address - Phone:719-502-7031
Mailing Address - Fax:
Practice Address - Street 1:5390 N ACADEMY BLVD STE 330
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4176
Practice Address - Country:US
Practice Address - Phone:719-502-7031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty