Organization
MIND AND SOUL PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MEDINA APRN-MSN (PMHNP-BC)
(720) 587-9702
Entity
Organization
Contact information
Practice address
2505 MINER ST, IDAHO SPRINGS, CO 80452-5112
(720) 587-9702
Mailing address
2505 MINER ST # 1926, IDAHO SPRINGS, CO 80452-5112
(720) 587-9702
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/08/2022
Last updated
07/15/2022
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