VISTAS PEDIATRIC AND FAMILY MENTAL WELLNESS NPI 1205526308

NPI Information

NPI: 1205526308
Provider Name: VISTAS PEDIATRIC AND FAMILY MENTAL WELLNESS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
698 BRIGGS ST.
SUITE 4
ERIE, CO
ZIP 80516
Phone: (720) 324-7158
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VISTAS PEDIATRIC AND FAMILY MENTAL WELLNESS is a psychiatric/mental health nurse practitioner in Erie, CO. VISTAS PEDIATRIC AND FAMILY MENTAL WELLNESS NPI is 1205526308. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

698 BRIGGS ST.
SUITE 4
ERIE, CO
ZIP 80516
Phone: (720) 324-7158
Fax: (833) 547-1923

The provider's authorized official is Jennifer Crowe .
The authorized official title is Owner/provider and has the following contact phone number (303) 945-9676.

The enumeration date for this NPI number is 5/11/2023 and was last updated on 4/1/2024.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9000222832	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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