MEDICARE: MICHELLE EGBERT FNP, PMHNP

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
1	363LF0000X	Family Nurse Practitioner	APN.0996218-NP	CO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0996218-NP	CO

General Provider Information

NPI Number	:	1205420056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE EGBERT FNP, PMHNP

Provider Business Mailing Address
First Line	:	3720 SINTON RD STE 104
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-5085
Country	:	US
Telephone Number	:	719-493-9555
Fax Number	:

Provider Business Practice Location Address
First Line	:	5278 FRASER VALLEY LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924-8205
Country	:	US
Telephone Number	:	719-826-6605
Fax Number	:	719-888-1718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	03/10/2025

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