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General NPI Number Information
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NPI Number | 1326521501
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Entity Type | Individual
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Provider Name | DAE K HAN FNP
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Gender | Male
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FORT CARSON
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 719-526-3668
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Fax | 719-524-2258
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Provider Business Mailing Address
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Address Line | 432 COBBLESTONE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-7631
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Country | US
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Telephone | 626-244-5514
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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 | NP950009277
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License Number State | CA
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