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General NPI Number Information
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NPI Number | 1386361731
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Entity Type | Organization
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Legal Business Name | MIND BODY NP LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1557 N OGDEN ST
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City | DENVER
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State | CO
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Zip | 80218-1489
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Country | US
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Telephone | 410-844-6401
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Fax |
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Provider Business Mailing Address
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Address Line | 6223 BIG BEND CV
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City | SAN ANTONIO
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State | TX
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Zip | 78253-5526
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Country | US
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Telephone | 410-844-6401
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Fax | 844-820-7074
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Authorized Official
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Title or Position | OWNER
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Name | SARAH JENKINS
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Credential | NP
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Telephone | 410-844-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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