Healthcare Provider Details

I. General information

NPI: 1730529520
Provider Name (Legal Business Name): LISA MESQEL' PETERSON ACNP, FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOYAL MENTAL HEALTH

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 S RIO GRANDE AVE
MONTROSE CO
81401-4847
US

IV. Provider business mailing address

1677 NIAGARA RD
MONTROSE CO
81401-5072
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-7751
  • Fax: 970-249-5029
Mailing address:
  • Phone: 970-432-8193
  • Fax: 970-410-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0992858
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0992858
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0992858
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: