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NPI Code Detail

MEDICARE: DR. CALLISON ANN KERNICK PSY.D.

MEDICARE:  DR. CALLISON ANN KERNICK  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist6554CO

General Provider Information

NPI Number : 1134604507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALLISON ANN KERNICK PSY.D.
Provider Business Mailing Address
First Line : 1660 S ALBION ST STE 602
Second Line :
City : DENVER
State : CO
Zip : 80222-4044
Country : US
Telephone Number : 720-515-8817
Fax Number :
Provider Business Practice Location Address
First Line : 1660 S ALBION ST STE 602
Second Line :
City : DENVER
State : CO
Zip : 80222-4044
Country : US
Telephone Number : 720-515-8817
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2018
Last Update Date : 11/06/2024

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Directions to “ DR. CALLISON ANN KERNICK PSY.D.” Practice Location

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