Provider Demographics
NPI:1437045044
Name:VIBRANT HEALTHCARE LLC
Entity type:Organization
Organization Name:VIBRANT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:VESSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-632-4455
Mailing Address - Street 1:685 CITADEL DR E STE 505
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5372
Mailing Address - Country:US
Mailing Address - Phone:719-632-4455
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:685 CITADEL DR E STE 505
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5372
Practice Address - Country:US
Practice Address - Phone:719-632-4455
Practice Address - Fax:303-306-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care