Healthcare Provider Details

I. General information

NPI: 1427714088
Provider Name (Legal Business Name): ROCKY MOUNTAIN MEDICAL & HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 E MISSISSIPPI AVE UNIT B
DENVER CO
80247-2427
US

IV. Provider business mailing address

6850 E EVANS AVE STE 102
DENVER CO
80224-2300
US

V. Phone/Fax

Practice location:
  • Phone: 303-696-1395
  • Fax:
Mailing address:
  • Phone: 303-691-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISINDA POWELL
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 720-506-1193