MEDICARE: MRS. GABRIELE MICHAELA HARRISON PMHNP

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
1	163W00000X	Registered Nurse	RN-193907	CO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0993676-NP	CO

General Provider Information

NPI Number	:	1740524693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GABRIELE MICHAELA HARRISON PMHNP

Provider Business Mailing Address
First Line	:	4601 CORBETT DR
Second Line	:
City	:	FT. COLLINS
State	:	CO
Zip	:	80528
Country	:	US
Telephone Number	:	970-207-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 CORBETT DR
Second Line	:
City	:	FT. COLLINS
State	:	CO
Zip	:	80528
Country	:	US
Telephone Number	:	970-207-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	07/03/2018

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