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General NPI Number Information
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NPI Number | 1760218663
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Entity Type | Individual
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Provider Name | MARY LEE STURGIS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2960 N CIRCLE DR STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1163
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Country | US
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Telephone | 719-208-4027
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Fax | 719-426-2525
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Provider Business Mailing Address
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Address Line | 2960 N CIRCLE DR STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1163
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Country | US
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Telephone | 719-208-4027
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Fax | 719-426-2525
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0102847
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License Number State | CO
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