Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP126647 | TX |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN.0994550-NP | CO |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | C-APN.0000882-C-NP | CO |
NPI | 1013311216 |
---|---|
Provider Name | Peter J Dahlberg |
First Address | Denver, CO 80237-3499 |
Second Address | Arvada, CO 80002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2014 |
Last Update Date | 14/03/2019 |