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Organization
WHOLE MOON HEALING LLC
Active
Organization
WHOLE MOON HEALING LLC
Active
Other names
Jade Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH CONNOR PMHNP (OWNER)
(720) 445-1258
Entity
Organization
Contact information
Practice address
2519 S SHIELDS ST, FORT COLLINS, CO 80526-1855
(970) 235-1112
Mailing address
2519 S SHIELDS ST STE 1K, FORT COLLINS, CO 80526-1855
(970) 235-1112
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/16/2025
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