MEDICARE: KARI WHITAKER WHEELER MSN, RN, 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
1	163W00000X	Registered Nurse	RN.0150155	CO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.1000241-NP	CO

General Provider Information

NPI Number	:	1801382569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI WHITAKER WHEELER MSN, RN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1915 LAKESPUR LN
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-2456
Country	:	US
Telephone Number	:	303-880-4534
Fax Number	:

Provider Business Practice Location Address
First Line	:	698 BRIGGS STREET
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-324-7158
Fax Number	:	833-547-1923

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

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	10/31/2024

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