Healthcare Provider Details

I. General information

NPI: 1447115530
Provider Name (Legal Business Name): MAVIS MESI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4065 ST CLOUD DR UNIT 200
LOVELAND CO
80538-9233
US

IV. Provider business mailing address

17855 DALLAS PKWY STE 200
DALLAS TX
75287-6857
US

V. Phone/Fax

Practice location:
  • Phone: 303-500-4852
  • Fax:
Mailing address:
  • Phone: 303-428-3107
  • Fax: 224-532-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001374-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: