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General NPI Number Information
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NPI Number | 1538904735
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Entity Type | Organization
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Legal Business Name | PSYCH NP PLLC
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Dates
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Enumeration Date | 06/28/2024
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 2320 W COLORADO AVE STE 118
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-3354
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Country | US
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Telephone | 719-581-7110
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Fax | 719-581-7114
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Provider Business Mailing Address
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Address Line | 2320 W COLORADO AVE STE 118
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-3354
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Country | US
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Telephone | 719-581-7110
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Fax | 719-581-7114
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Authorized Official
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Title or Position | OWNER, PMHNP
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Name | SHANNON STONE
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Credential |
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Telephone | 719-581-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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