Healthcare Provider Details

I. General information

NPI: 1992641286
Provider Name (Legal Business Name): KATHLEEN O'MALLEY APN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 HARLAN ST UNIT 250
WESTMINSTER CO
80031-2973
US

IV. Provider business mailing address

3021 LEAFDALE DR
CASTLE ROCK CO
80109-3760
US

V. Phone/Fax

Practice location:
  • Phone: 720-458-5413
  • Fax:
Mailing address:
  • Phone: 847-431-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1001911
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: