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NPI Code Detail

MEDICARE: KALEY BISHARD PMHNP-BC, RN

MEDICARE: KALEY BISHARD PMHNP-BC, RN
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
1163W00000XRegistered NurseC-RXN.0001087-C-NPCO
2163W00000XRegistered NurseRN-204924CO
3163W00000XRegistered Nurse28186184AIN
4363LP0808XPsychiatric/Mental Health Nurse Practitioner0990416CO
5363LP0808XPsychiatric/Mental Health Nurse PractitionerC-APN.0002416-C-NPCO

General Provider Information

NPI Number : 1558621805
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALEY BISHARD PMHNP-BC, RN
Provider Business Mailing Address
First Line : 4856 INNOVATION DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5540
Country : US
Telephone Number : 970-494-4200
Fax Number : 970-613-4475
Provider Business Practice Location Address
First Line : 700 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1842
Country : US
Telephone Number : 970-494-4200
Fax Number : 970-399-8037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2012
Last Update Date : 10/12/2022

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