Healthcare Provider Details

I. General information

NPI: 1659236339
Provider Name (Legal Business Name): LISA VARGO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 28 3/4 RD BLDG F
GRAND JUNCTION CO
81501-5016
US

IV. Provider business mailing address

PO BOX 3807
GRAND JUNCTION CO
81502-3807
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-4213
  • Fax: 970-243-8631
Mailing address:
  • Phone: 970-683-7131
  • Fax: 970-243-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.1659005
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1659005
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: