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General NPI Number Information
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NPI Number | 1669181384
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Entity Type | Organization
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Legal Business Name | PERSEVERE HEALTHCARE
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 6475 WALL ST # 130
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-8337
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Country | US
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Telephone | 414-841-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 3912 RIVIERA GRV APT 204
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-3365
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Country | US
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Telephone | 414-788-0008
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Fax |
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Authorized Official
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Title or Position | OWNER/FNP/COACH
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Name | MICHELE ALI
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Credential | FNP, NHA
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Telephone | 414-788-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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