Healthcare Provider Details

I. General information

NPI: 1427412501
Provider Name (Legal Business Name): DEANNA PSAHOS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 S SYCAMORE ST
LITTLETON CO
80120-8201
US

IV. Provider business mailing address

155 INVERNESS DR W SUITE 200
ENGLEWOOD CO
80112-5095
US

V. Phone/Fax

Practice location:
  • Phone: 720-696-7425
  • Fax: 303-703-3487
Mailing address:
  • Phone: 720-696-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN34798
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: