MASTERMIND CLINIC PLLC NPI 1285247486

NPI Information

MASTERMIND CLINIC PLLC is a psychiatric/mental health nurse practitioner in Colorado Springs, CO. MASTERMIND CLINIC PLLC NPI is 1285247486. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

320 E FONTANERO ST STE 301
COLORADO SPRINGS, CO
ZIP 80907-526
Phone: (719) 644-6463
Fax: (844) 579-0123

The provider's authorized official is Jennie Stormes .
The authorized official title is Managing Officer and has the following contact phone number (209) 327-3366.

The CLIA number assigned to this NPI record is 06D2196076 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/26/2020 and was last updated on 8/26/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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