Healthcare Provider Details

I. General information

NPI: 1811767072
Provider Name (Legal Business Name): SHAREESE KARIN MULHOLAND DEPOLD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax: 303-602-5184
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-602-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999417-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: