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General NPI Number Information
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NPI Number | 1144846700
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Entity Type | Individual
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Provider Name | DEIMYS DAILY VIGIL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 12760 STROH RANCH WAY STE 203
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City | PARKER
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State | CO
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Zip | 80134-7507
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Country | US
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Telephone | 720-458-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 16592 HIGH DESERT PL
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City | PARKER
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State | CO
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Zip | 80134-3044
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Country | US
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Telephone | 720-458-5415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0995555-NP
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License Number State | CO
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