| Well Nourished Llc | |
|
2801 Youngfield St Ste 101 Golden CO 80401-0208 | |
| (720) 241-2489 | |
| Not Available |
| Full Name | Well Nourished Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2801 Youngfield St Ste 101, Golden, Colorado |
| Authorized Official Name and Position | Hope Manning (PA-C) |
| Authorized Official Contact | 7202412489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Well Nourished Llc 2801 Youngfield St Ste 101 Golden CO 80401-0208 Ph: (720) 241-2489 | Well Nourished Llc 2801 Youngfield St Ste 101 Golden CO 80401-0208 Ph: (720) 241-2489 |
| NPI Number | 1598409468 |
|---|---|
| Provider Enumeration Date | 04/26/2022 |
| Last Update Date | 07/26/2024 |
| Certification Date | 07/26/2024 |
| Medicare PECOS PAC ID | 6608249669 |
|---|---|
| Medicare Enrollment ID | O20230222002974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598409468 | NPI | - | NPPES |
| Provider Name | Regina Leverrier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861557506 PECOS PAC ID: 0345232104 Enrollment ID: I20090902000036 |
| Provider Name | Veronica Koestler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922553890 PECOS PAC ID: 2466740436 Enrollment ID: I20220901002074 |
| Provider Name | Shanna Haydu Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780360065 PECOS PAC ID: 5496115628 Enrollment ID: I20230719001044 |
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