MEDICARE: THRIVE HEALTH AND WELLNESS

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1902599012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	88 INVERNESS CIR E UNIT A204
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5521
Country	:	US
Telephone Number	:	303-790-8446
Fax Number	:	303-799-8175

Provider Business Practice Location Address
First Line	:	88 INVERNESS CIR E UNIT A204
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5521
Country	:	US
Telephone Number	:	303-790-8446
Fax Number	:	303-799-8175

Authorized Official
Title or Position	:	OWNER-ADMINISTARTOR
Name	:	DOUG HATCH
Credential	:
Telephone Number	:	303-790-8446

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/02/2023

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Directions to “THRIVE HEALTH AND WELLNESS ” Practice Location

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