Organization
INTEGRATIVE PEDIATRIC HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GAUGHAN MS, RN, CPNP (MEMBER, PRACTITIONER)
(719) 494-5123
Entity
Organization
Contact information
Practice address
3540 S POPLAR ST STE 202, DENVER, CO 80237-1362
(720) 442-3615
(720) 870-3726
Mailing address
3540 S POPLAR ST STE 202, DENVER, CO 80237-1362
(720) 442-3615
(720) 870-3726
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10820051
—
CO
Enumeration date
09/22/2015
Last updated
02/03/2021
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