Healthcare Provider Details

I. General information

NPI: 1467019364
Provider Name (Legal Business Name): KESHEA DESMORNES ROUSE AGPCNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KESHEA C DESMORNES

II. Dates (important events)

Enumeration Date: 05/26/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 INVERNESS DR E STE 270
ENGLEWOOD CO
80112-5135
US

IV. Provider business mailing address

63 INVERNESS DR E STE 270
ENGLEWOOD CO
80112-5135
US

V. Phone/Fax

Practice location:
  • Phone: 719-245-0135
  • Fax: 719-245-0136
Mailing address:
  • Phone: 719-245-0135
  • Fax: 719-245-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1000730-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberAPN.1000730-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: