Provider Demographics
NPI:1467776344
Name:ERICKSON GEISNESS, NISSA MARIE (CNM, NP)
Entity Type:Individual
Prefix:
First Name:NISSA
Middle Name:MARIE
Last Name:ERICKSON GEISNESS
Suffix:
Gender:F
Credentials:CNM, NP
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Mailing Address - Street 1:7780 S BROADWAY
Mailing Address - Street 2:SUITE 280
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2648
Mailing Address - Country:US
Mailing Address - Phone:303-738-1100
Mailing Address - Fax:303-738-8202
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 280
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-738-1100
Practice Address - Fax:303-738-8202
Is Sole Proprietor?:No
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CONP-10176363LW0102X
COCNM-5939367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health