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General NPI Number Information
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NPI Number | 1447414172
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Entity Type | Organization
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Legal Business Name | CHEYENNE MOUNTAIN FAMILY PRACTICE
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 125 SWOPE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5832
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Country | US
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Telephone | 719-634-4746
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Fax | 719-634-5024
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Provider Business Mailing Address
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Address Line | 125 SWOPE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5832
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Country | US
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Telephone | 719-634-4746
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Fax | 719-634-5024
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BARBARA JEAN STARKEY
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Credential | FNP
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Telephone | 719-634-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 126800
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License Number State | CO
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