Provider Demographics
NPI:1598810566
Name:MARK, CHERYL L (NP)
Entity Type:Individual
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First Name:CHERYL
Middle Name:L
Last Name:MARK
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Gender:F
Credentials:NP
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-788-6657
Mailing Address - Fax:303-788-8837
Practice Address - Street 1:10103 RIDGEGATE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5520
Practice Address - Country:US
Practice Address - Phone:303-788-6657
Practice Address - Fax:303-788-8837
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2022-02-10
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Provider Licenses
StateLicense IDTaxonomies
CO92234363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07684321Medicaid
COP00387159OtherRAILROAD MEDICARE
COP00387159OtherRAILROAD MEDICARE
COC802063Medicare PIN
COQ45081Medicare UPIN