Healthcare Provider Details

I. General information

NPI: 1215674635
Provider Name (Legal Business Name): DAVID GELDERT MSN-PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S BROADWAY STE 200-284
DENVER CO
80209-1558
US

IV. Provider business mailing address

303 S BROADWAY STE 200-284
DENVER CO
80209-1558
US

V. Phone/Fax

Practice location:
  • Phone: 970-614-5577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0997587-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: