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General NPI Number Information
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NPI Number | 1700554896
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Entity Type | Organization
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Legal Business Name | ELEVATED FAMILY WELLNESS PLLC
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 2020 W COLORADO AVE STE 202
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-3863
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Country | US
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Telephone | 719-646-6746
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Fax |
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Provider Business Mailing Address
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Address Line | 10211 EVENING VISTA DR
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City | PEYTON
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State | CO
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Zip | 80831-8321
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Country | US
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Telephone | 262-488-7278
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MAGGIE SCHUMM
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Credential | FNP
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Telephone | 262-488-7278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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