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General NPI Number Information
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NPI Number | 1578932539
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Entity Type | Organization
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Legal Business Name | CHERRY CREEK FAMILY MEDICINE
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 6551 S REVERE PKWY SUITE 120
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City | CENTENNIAL
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State | CO
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Zip | 80111
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Country | US
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Telephone | 720-699-7672
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Fax | 720-699-7673
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Provider Business Mailing Address
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Address Line | 6551 S REVERE PKWY STE 120
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City | CENTENNIAL
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State | CO
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Zip | 80111-6410
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Country | US
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Telephone | 720-699-7672
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Fax | 720-699-7673
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Authorized Official
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Title or Position | OWNER
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Name | MONICA GARBISO
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Credential | NP
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Telephone | 719-671-3097
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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 | APN0010276NP
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License Number State | CO
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