Healthcare Provider Details

I. General information

NPI: 1952122376
Provider Name (Legal Business Name): MARLYSE JOY RAPPOPORT PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 W DRY CREEK CIR STE 600
LITTLETON CO
80120-4659
US

IV. Provider business mailing address

26 W DRY CREEK CIR STE 600
LITTLETON CO
80120-4659
US

V. Phone/Fax

Practice location:
  • Phone: 303-877-8439
  • Fax: 570-255-7936
Mailing address:
  • Phone: 303-877-8439
  • Fax: 303-567-8356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1000211-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: