Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Colorado Dermatology Clinic PC

Organization Dermatology Physician · NPI 1548409139

Southern Colorado Dermatology Clinic PC is a Dermatology Physician in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2009.

Licensed in
CO
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

900 Indiana Ave Ste C
Pueblo, CO 81004-3767
Phone: (719) 564-5544
Fax: (719) 564-2246
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 44146 (CO)

Record details

NPI number1548409139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Krystal Nakamura — Owner · (719) 564-5544
NPI enumeratedFebruary 5, 2009
Last updated in NPPESMay 25, 2021
Certification dateMay 25, 2021
Mailing address900 Indiana Ave Ste C, Pueblo, CO 81004-3767

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