Individual
RICHARD DAVID WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4597
(303) 436-6000
Mailing address
155 INVERNESS DR W, ENGLEWOOD, CO 80112-5095
(303) 730-8858
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1866
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0992126-NP
CO
Other
Enumeration date
10/27/2011
Last updated
03/02/2021
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