Healthcare Provider Details
I. General information
NPI: 1609038330
Provider Name (Legal Business Name): MARY VANOYEN FORCE MS, ANP-BC, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/25/2008
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2125 E LA SALLE ST
COLORADO SPRINGS CO
80909-2274
US
IV. Provider business mailing address
2125 E LA SALLE ST
COLORADO SPRINGS CO
80909-2274
US
V. Phone/Fax
- Phone: 719-219-3402
- Fax:
- Phone: 719-219-3402
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 041317990 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 209007044 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 209007044 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | APN.0990591-NP |
| License Number State | CO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | RN.1619124 |
| License Number State | CO |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 4704131231 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: