Healthcare Provider Details

I. General information

NPI: 1578644043
Provider Name (Legal Business Name): DENISE MARY CHISM MSN, PNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E HAMPDEN AVE SUITE 100
ENGLEWOOD CO
80113-2547
US

IV. Provider business mailing address

180 E HAMPDEN AVE SUITE 100
ENGLEWOOD CO
80113-2547
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-4968
  • Fax: 303-789-6018
Mailing address:
  • Phone: 303-789-4968
  • Fax: 303-789-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number99483
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: