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NPI Code Detail

MEDICARE: JACOB CALLAHAN RN

MEDICARE: JACOB CALLAHAN 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
1163WP0808XPsychiatric/Mental Health Registered NurseRN.1681806CO
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.1001630-NPCO

General Provider Information

NPI Number : 1821776071
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB CALLAHAN RN
Provider Business Mailing Address
First Line : 4851 INDEPENDENCE ST
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-425-0300
Fax Number :
Provider Business Practice Location Address
First Line : 4851 INDEPENDENCE ST
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-425-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2023
Last Update Date : 03/17/2026

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