COLORADO STATE UNIVERSITY PUEBLO
NPI 1467225730
Nurse Practitioner - Family in Pueblo, CO

Q: What is Colorado State University Pueblo's NPI number?

The NPI number for Colorado State University Pueblo is 1467225730. It was assigned to this organization in the NPPES registry on October 30, 2023. The provider is doing business as Wolfpack Wellness Center.

Q: What is Colorado State University Pueblo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since October 30, 2023

2200 BONFORTE BLVD # 172, PUEBLO, CO 81001(719) 549-2830(719) 549-2646 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Colorado State University Pueblo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLORADO STATE UNIVERSITY PUEBLO (NPI 1467225730), doing business as Wolfpack Wellness Center, is a healthcare organization registered as a family in Pueblo, Colorado and active in the NPI registry since October 2023. The organization lists Carolyn Kay Daugherty, Assistant Dean, as its authorized official.

NPPES Registry Identity

NPI1467225730

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameCOLORADO STATE UNIVERSITY PUEBLO

Location Address2200 BONFORTE BLVD # 172Pueblo, CO 81001-4901

Mailing Address2200 Bonforte Blvd # 172Pueblo, CO 81001-4901 · (719) 549-2830 · Fax (719) 549-2646

Phone(719) 549-2830

Fax(719) 549-2646

Organization SubpartNo

Authorized OfficialCarolyn Kay DaughertyAssistant Dean · (719) 549-2830

Enumeration DateOctober 30, 2023

NPPES CertifiedOctober 30, 2023

✔ NPI 1467225730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

2200 BONFORTE BLVD # 172, Pueblo, CO 81001

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Other Names 1

Doing Business AsWolfpack Wellness Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colorado State University Pueblo's NPI number?

The NPI number for Colorado State University Pueblo is 1467225730. It was assigned to this organization in the NPPES registry on October 30, 2023. The provider is doing business as Wolfpack Wellness Center.

Where is Colorado State University Pueblo located?

Colorado State University Pueblo is located at 2200 Bonforte Blvd # 172, Pueblo, CO 81001. The listed phone number is (719) 549-2830.

What is Colorado State University Pueblo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Colorado State University Pueblo was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.