Organization · Type 2 NPI

Revive of Colorado, PLLC

Nurse Practitioner · Colorado Springs, CO

NPI number 1609372838 Active

Practice location

218 E Cheyenne Mountain Blvd
Colorado Springs, CO 80906-3720

Fax (719) 396-3003

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	AG09170063 (CO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1609372838

Revive of Colorado, PLLC's National Provider Identifier is 1609372838, issued on Apr 5, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Colorado Springs, CO. The record was last updated on Apr 5, 2018.