Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN.0990710-NP | CO |
Y | 363L00000X | Nurse Practitioner | RXN.0101194-NP | CO |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN.0990710-NP | CO |
NPI | 1013252758 |
---|---|
Provider Name | Sally Mescher Allen |
First Address | Aurora, CO 80011-7117 |
Second Address | Aurora, CO 80011-7112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2012 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31480021 | (05) | CO |
380292YLUM | (02) | CO |
MM3455688 | DEA (01) | CO |