Healthcare Provider Details

I. General information

NPI: 1083524961
Provider Name (Legal Business Name): CHARISSE NICHOLE MEIREIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 KITTREDGE ST
DENVER CO
80239-5802
US

IV. Provider business mailing address

208 N 45TH AVENUE CT
GREELEY CO
80634-1085
US

V. Phone/Fax

Practice location:
  • Phone: 720-808-0455
  • Fax:
Mailing address:
  • Phone: 714-822-7768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1654055
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: