Healthcare Provider Details

I. General information

NPI: 1669488318
Provider Name (Legal Business Name): EVELYN HOPE MENA CNS, RXN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOPE MENA CNS, RXN

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 S CIRCLE DR SUITE 160
COLORADO SPRINGS CO
80906-4113
US

IV. Provider business mailing address

2860 S CIRCLE DR SUITE 160
COLORADO SPRINGS CO
80906-4113
US

V. Phone/Fax

Practice location:
  • Phone: 719-473-2346
  • Fax: 719-577-9627
Mailing address:
  • Phone: 719-473-2346
  • Fax: 719-577-9627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number73993
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: