Healthcare Provider Details

I. General information

NPI: 1356193130
Provider Name (Legal Business Name): CHARMAGNE LYNN YOKOYAMA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8835 AMERICAN WAY
ENGLEWOOD CO
80112-7056
US

IV. Provider business mailing address

13164 PEACOCK DR
LITTLETON CO
80124-2622
US

V. Phone/Fax

Practice location:
  • Phone: 720-643-4300
  • Fax:
Mailing address:
  • Phone: 720-984-5636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN.0999672-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: