Healthcare Provider Details

I. General information

NPI: 1881526655
Provider Name (Legal Business Name): ANN ELIZABETH WAHOUSKE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2205 CORDILLERA WAY
EDWARDS CO
81632-6290
US

IV. Provider business mailing address

PO BOX 725
EAGLE CO
81631-0725
US

V. Phone/Fax

Practice location:
  • Phone: 970-237-6340
  • Fax:
Mailing address:
  • Phone: 970-331-5498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1001761-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: