Healthcare Provider Details

I. General information

NPI: 1841936846
Provider Name (Legal Business Name): HANNAH GUNNISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 S PARKER RD STE 100
DENVER CO
80231-2177
US

IV. Provider business mailing address

2680 18TH ST APT 309
DENVER CO
80211-4497
US

V. Phone/Fax

Practice location:
  • Phone: 844-455-2747
  • Fax:
Mailing address:
  • Phone: 913-669-2685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberC-APN.0003998-C-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberC-APN.0003998-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: