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NPI Code Detail

MEDICARE: SALLY POWELL PMHNP-BC

MEDICARE: SALLY POWELL PMHNP-BC
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
1163W00000XRegistered Nurse199087CO
2163WP0808XPsychiatric/Mental Health Registered Nurse199087CO
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.0998981-NPCO

General Provider Information

NPI Number : 1356639330
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY POWELL PMHNP-BC
Provider Business Mailing Address
First Line : 5335 W 48TH AVE STE 500
Second Line :
City : DENVER
State : CO
Zip : 80212-2732
Country : US
Telephone Number : 303-578-6996
Fax Number : 847-789-4451
Provider Business Practice Location Address
First Line : 5335 W 48TH AVE STE 500
Second Line :
City : DENVER
State : CO
Zip : 80212-2732
Country : US
Telephone Number : 303-578-6996
Fax Number : 847-789-4451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2011
Last Update Date : 03/05/2025

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