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General NPI Number Information
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NPI Number | 1245914001
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Entity Type | Individual
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Provider Name | MARY GRACE LEVY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2920 N CASCADE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6262
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Country | US
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Telephone | 719-227-0027
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Fax | 719-955-4058
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Provider Business Mailing Address
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Address Line | 5021 COPEN DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2127
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Country | US
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Telephone | 702-637-8531
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0998523-NP
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License Number State | CO
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