Individual
MARK JANKELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1318 W COLORADO AVE, COLORADO SPRINGS, CO 80904-4023
(719) 766-8511
(719) 208-7731
Mailing address
1318 W COLORADO AVE, COLORADO SPRINGS, CO 80904-4023
(719) 766-8511
(719) 208-7731
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
ANP0990467
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0990467-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87108518
—
CO
Enumeration date
12/22/2010
Last updated
10/05/2023
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