Healthcare Provider Details

I. General information

NPI: 1235599085
Provider Name (Legal Business Name): MAMA NURTURE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2016
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1888 S JACKSON ST 102
DENVER CO
80210-3924
US

IV. Provider business mailing address

1888 S JACKSON ST 102
DENVER CO
80210-3924
US

V. Phone/Fax

Practice location:
  • Phone: 256-698-2261
  • Fax:
Mailing address:
  • Phone: 256-698-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateCO

VIII. Authorized Official

Name: MEGAN E DEMPSEY
Title or Position: FOUNDER
Credential: CD(DONA), BCTMB, CBS
Phone: 256-698-2261