| NPI | 1760928766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K CHISM Owner/Np 720-507-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2023-05-17 |