| NPI | 1881413896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKLAUS RENDLER Credentialing And Business Manager 719-251-5132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-25 |