| NPI | 1902652340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE WORSHAM Manager, Credentialing & Enrollment 303-384-4064 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 2086S0129X |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2025-10-22 |