Healthcare Provider Details

I. General information

NPI: 1922945005
Provider Name (Legal Business Name): KAHESHA RICARD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6377 S REVERE PKWY STE 300
CENTENNIAL CO
80111-6488
US

IV. Provider business mailing address

22010 E AURORA PKWY UNIT 1431
AURORA CO
80016-6285
US

V. Phone/Fax

Practice location:
  • Phone: 720-577-4002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1002023
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1709168
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: