MEDICARE: ZENLIFE PSYCHIATRIC SERVICES

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1386342715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZENLIFE PSYCHIATRIC SERVICES

Provider Business Mailing Address
First Line	:	312 W 2ND ST STE 3830
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2412
Country	:	US
Telephone Number	:	760-358-4144
Fax Number	:	760-452-7802

Provider Business Practice Location Address
First Line	:	312 W 2ND ST STE 3830
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2412
Country	:	US
Telephone Number	:	760-358-4144
Fax Number	:	760-452-7802

Authorized Official
Title or Position	:	PMHNP
Name	:	KAREN VOGEL
Credential	:	MSN
Telephone Number	:	760-680-6816

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	03/28/2023

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