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

Dr. Queenter Kisang, MD

Individual provider Family Medicine Physician · NPI 1033773627

Dr. Queenter Kisang, MD is a Family Practice in Pueblo, Colorado. Qualified in 2019, 7 years ago. Practices with Southern Colorado Clinic PC, a 37-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado.

Years since qualifying
7
Licensed in
CO
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3676 Parker Blvd
Pueblo, CO 81008-2212
Phone: (719) 553-1804
Fax: (833) 916-2047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DR.006687 (CO)

Record details

NPI number1033773627
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 29, 2019
Last updated in NPPESMay 20, 2024
Certification dateMay 20, 2024
Mailing addressPo Box 9000, Pueblo, CO 81008-9000

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Southern Colorado Clinic Pc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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