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NPI Code Detail

MEDICARE: JORGE S CORREIA PMHNP-BC

MEDICARE: JORGE S CORREIA PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.0996956-NPCO

General Provider Information

NPI Number : 1700557287
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE S CORREIA PMHNP-BC
Provider Business Mailing Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 720-679-8259
Fax Number : 888-437-8409
Provider Business Practice Location Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 720-679-8259
Fax Number : 888-437-8409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 03/28/2026

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Directions to “ JORGE S CORREIA PMHNP-BC” Practice Location

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