Individual
MS. INDIZO STAR MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PMHNP
Contact information
Practice address
8490 E CRESCENT PKWY STE 200, GREENWOOD VILLAGE, CO 80111-2802
(720) 316-6434
Mailing address
2831 N YORK ST, DENVER, CO 80205-4658
(808) 345-7393
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.1627689
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0997135-NP
CO
Other
Enumeration date
01/27/2016
Last updated
05/20/2024
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