MEDICARE: KATHLEEN O'MALLEY APN, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.1001911	CO

General Provider Information

NPI Number	:	1992641286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN O'MALLEY APN, PMHNP-BC

Provider Business Mailing Address
First Line	:	3021 LEAFDALE DR
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-3760
Country	:	US
Telephone Number	:	847-431-8382
Fax Number	:

Provider Business Practice Location Address
First Line	:	9101 HARLAN ST UNIT 250
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-2973
Country	:	US
Telephone Number	:	720-458-5413
Fax Number	:

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

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	06/03/2026

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