| NPI | 1750245122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHEYENNE ELAINE SHIPMAN Board Member 719-252-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171400000X Health & Wellness Coach | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2025-12-10 |
| Last Update Date | 2025-12-18 |