Provider Demographics
NPI:1568948313
Name:PARMENTER, SAMUEL I (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:I
Last Name:PARMENTER
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 NOB HILL RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7862
Mailing Address - Country:US
Mailing Address - Phone:812-821-7130
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 950
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2843
Practice Address - Country:US
Practice Address - Phone:720-254-1353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993983363LP0808X
IN71014881A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health