Individual
MARIAH LYNN DEGUSSEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
9362 TEDDY LN STE 103&104, LONE TREE, CO 80124-2870
(303) 955-7545
Mailing address
3424 MEADE ST, DENVER, CO 80211-3141
(760) 650-5773
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0998274
CO
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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