Healthcare Provider Details

I. General information

NPI: 1598506990
Provider Name (Legal Business Name): TRAVIS ANSELMO DEANGELIS MSN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 E HAMPDEN AVE STE 352
DENVER CO
80231-4838
US

IV. Provider business mailing address

7535 E HAMPDEN AVE STE 352
DENVER CO
80231-4838
US

V. Phone/Fax

Practice location:
  • Phone: 720-953-3898
  • Fax: 720-953-3898
Mailing address:
  • Phone: 720-953-3898
  • Fax: 720-953-3898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRXN.0108854-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0999792-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: