Individual provider · Type 1 NPI
Mallory B. Hommertzheim, NP
Family Nurse Practitioner · Colorado Springs, CO
NPI number
1073154787
Active
Practice location
595 Chapel Hills Dr Ste 303B
Colorado Springs, CO 80920-1022
Fax (719) 888-1841
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 113578 (OK) |
| Family Nurse Practitioner Primary | 363LF0000X | 1257 (CO) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1073154787
Mallory B. Hommertzheim, NP's National Provider Identifier is 1073154787, issued on Oct 3, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Colorado Springs, CO. The record was last updated on Mar 24, 2026.