Healthcare Provider Details

I. General information

NPI: 1629837067
Provider Name (Legal Business Name): NANCIE C ZIEMKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 S HUDSON ST
DENVER CO
80222-3932
US

IV. Provider business mailing address

1663 S HUDSON ST
DENVER CO
80222-3932
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-8479
  • Fax: 323-386-0773
Mailing address:
  • Phone: 720-507-8479
  • Fax: 323-386-0773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCIE C ZIEMKE
Title or Position: OWNER
Credential: PHD
Phone: 720-507-8479