MEDICARE: HOLLY VAUSE DNP, PMHNP

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	APN0005204NP	CO
2	363L00000X	Nurse Practitioner	164461	CO

General Provider Information

NPI Number	:	1831398403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY VAUSE DNP, PMHNP

Provider Business Mailing Address
First Line	:	90 MADISON ST STE 302
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-5412
Country	:	US
Telephone Number	:	720-331-6899
Fax Number	:	855-650-8805

Provider Business Practice Location Address
First Line	:	90 MADISON ST STE 302
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-5412
Country	:	US
Telephone Number	:	720-331-6899
Fax Number	:	720-889-9496

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	02/06/2025

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