Healthcare Provider Details

I. General information

NPI: 1770227035
Provider Name (Legal Business Name): JASMINE WOHLMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BRIARGATE PKWY STE 300
COLORADO SPRINGS CO
80920-7837
US

IV. Provider business mailing address

4110 BRIARGATE PKWY STE 300
COLORADO SPRINGS CO
80920-7837
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-7669
  • Fax:
Mailing address:
  • Phone: 719-640-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberANP.0997521-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: