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General NPI Number Information
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NPI Number | 1538313457
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Entity Type | Individual
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Provider Name | GINA MARIE MUNDELL FNP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 2920 N CASCADE AVE 3RD FLOOR
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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 | 719-636-1201
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Fax | 719-955-0986
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Provider Business Mailing Address
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Address Line | 2920 N CASCADE AVE 3RD FLOOR
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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 | 719-636-1201
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Fax | 719-955-0986
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | APN.0005322-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | APN.0005322-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0005322-NP
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 125863
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0005322
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License Number State | CO
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