Organization
REGENESIS WELLNESS LLC
Active
Other names
Regenesis Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA MARIA DOUGLAS FNP (OWNER)
(719) 428-5310
Entity
Organization
Contact information
Practice address
2310 VICKERS DR, COLORADO SPRINGS, CO 80918-1981
(719) 428-5310
(720) 504-0186
Mailing address
2310 VICKERS DR, COLORADO SPRINGS, CO 80918-1981
(719) 428-5310
(720) 504-0186
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
0990332-NP
CO
Other
Enumeration date
11/10/2015
Last updated
04/18/2018
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