Healthcare Provider Details

I. General information

NPI: 1598810566
Provider Name (Legal Business Name): CHERYL L MARK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY SUITE 200
LONE TREE CO
80124-5520
US

IV. Provider business mailing address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-6657
  • Fax: 303-788-8837
Mailing address:
  • Phone: 303-788-6657
  • Fax: 303-788-8837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number92234
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: