Individual
MALLORY B HOMMERTZHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
595 CHAPEL HILLS DR STE 303B, COLORADO SPRINGS, CO 80920-1022
(719) 922-1002
(719) 888-1841
Mailing address
595 CHAPEL HILLS DR STE 303B, COLORADO SPRINGS, CO 80920-1022
(719) 922-1002
(719) 888-1841
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
113578
OK
363LF0000X
Family Nurse Practitioner
Primary
1257
CO
Other
Enumeration date
10/03/2019
Last updated
03/24/2026
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