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NPI Code Detail

MEDICARE: MRS. MARY ANN ELIZABETH ALESSI-RICHARDS NURSE PRACTITIONER

MEDICARE: MRS. MARY ANN ELIZABETH ALESSI-RICHARDS NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner50628CO

General Provider Information

NPI Number : 1336194299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY ANN ELIZABETH ALESSI-RICHARDS NURSE PRACTITIONER
Provider Business Mailing Address
First Line : PO BOX 1391
Second Line :
City : CANON CITY
State : CO
Zip : 81215-1391
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3225 INDEPENDENCE RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9380
Country : US
Telephone Number : 719-275-2351
Fax Number : 719-269-9386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 12/23/2019

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