Healthcare Provider Details

I. General information

NPI: 1134986169
Provider Name (Legal Business Name): MEGAN VASQUEZ PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16500 S GOLDEN RD UNIT 316
GOLDEN CO
80401-3008
US

IV. Provider business mailing address

16500 S GOLDEN RD UNIT 316
GOLDEN CO
80401-3008
US

V. Phone/Fax

Practice location:
  • Phone: 239-206-7926
  • Fax:
Mailing address:
  • Phone: 239-206-7926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2372118
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1001398-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: